Evaluation of Basic Arrhythmia Knowledge Retention and Clinical Application by Registered Nurses

Monday, 7 July 2008
Lin-Ti Chang, BSN, MSN , Patient Care Services, Massachusetts General Hospital, Boston, MA
Sheila M. Burke, RN, BSN , The Institute for Patient Care, Massachusetts General Hospital, Boston, MA
Mary C. McAdams, RN, BSN, MEd , The Institute for Patient Care, Massachusetts General Hospital, Boston, MA
Laura Sumner, MEd, MSN, MBA , The Institute for Patient Care, Massachusetts General Hospital, Boston, MA

Learning Objective 1: evaluate knowledge retention over time after exposure to a basic arrhythmia program.

Learning Objective 2: evaluate clinical application of basic arrhythmia using simulation.

Competent and skilled practitioners are essential to promote high acuity, medically complex patient care. At a large academic center over 200,000 patients are treated annually in both inpatient or outpatient settings. All inpatient clinical care units have telemetry for cardiac monitoring. Registered Nurses (RNs) play a critical role in identifying basic arrhythmias / lethal arrhythmias, initiating resuscitation and notifying the physician.

Current practice is to offer a four-hour basic arrhythmia program in central registered nurse orientation on the second day of orientation. A basic arrhythmia posttest is completed by all RNs before the end of their unit orientation period and prior to caring for cardiac monitored patients. Currently, an 80% pass rate which includes correctly identifying lethal arrhythmias is the criteria needed for passing. There is no evidence to support competency in arrhythmia identification or knowledge retention following the orientation period.

The purpose of this study is to evaluate knowledge retention over time and clinical application of basic arrhythmias using simulation after exposure to a program on arrhythmias.

The design of the study is descriptive, repeated measures pretest, posttest in 4 weeks and at 3 months following the program using simulation generated arrhythmia scenarios. A convenience sample of all RNs in central hospital orientation who consent to participate and meet inclusion criteria will be included in the study. Sample size goal is 125 RNs. Data analysis is ongoing and focus on differences in pretest / posttest achievement and application of knowledge in clinical scenarios. Preliminary results suggest variable results in posttest scores and improvement in clinical application in simulation.