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Interprofessional teams with and without nurse practitioners and the level of adherence to best practice guidelines in cardiac surgery: A retrospective study

Abstract

Aim

To examine the level of adherence to best-practice guidelines of interprofessional teams with acute care nurse practitioners (ACNPs) compared to interprofessional teams without ACNPs.

Design

A retrospective observational study was conducted in 2023.

Method

A retrospective cohort was created including 280 patients who underwent a coronary artery bypass graft and/or a valve repair and hospitalised in a cardiac surgery unit of a university affiliated hospital in Québec (Canada) between 1 January 2019 to 31 January 2020.

The level of adherence to best-practice guidelines was measured from a composite score in percentage. The composite score was created from a newly developed tool including 99 items across six categories (patient information, pharmacotherapy, laboratory tests, post-operative assessment, patient and interprofessional teams' characteristics). Multivariate linear and logistic regression models were computed to examine the effect of interprofessional teams with ACNPs on the level of adherence to best-practice guidelines.

Results

Most of the patients of the cohort were male and underwent a coronary artery bypass graft procedure. Patients under the care of interprofessional teams with ACNP were 1.72 times more likely to reach a level of adherence higher than 80% compared to interprofessional teams without ACNPs and were 2.29 times more likely to be within the highest quartile of the scores for the level of adherence to best-practice guidelines of the cohort.

Impact

This study provides empirical data supporting the benefits of ACNP practice for patients, interprofessional teams and healthcare organisations.

Relevance for Practice

Our findings identify the important contributions of interprofessional teams that include ACNPs using a validated instrument, as well as their contribution to the delivery of high quality patient care.

Reporting Method

This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies guidelines.

Patient or Public Contribution

No patient or public contribution.

To die or not to die: manikin death in resuscitation simulation does not impact nursing students self-efficacy

Por: Lapierre · A. · Lavoie · P.

Commentary on: Tucker G, Urwin C, Unsworth J. The impact of unsuccessful resuscitation and manikin death during simulation on nursing student’s resuscitation self-efficacy: A quasi-experimental study. Nurse Educ Today. 2022 Dec;119:105587. doi: 10.1016/j.nedt.2022.105587. Epub 2022 Oct 4.

Implications for practice and research

  • A well-structured resuscitation simulation can improve nursing students’ self-efficacy, whether or not it ends with the death of the manikin.

  • Future research should examine the impact of manikin death on other essential factors that contribute to nursing students’ learning.

  • Context

    Simulation is widely used to train nursing students in assessing and managing cardiac arrest. However, considerable debate has been about whether the manikin should die due to unsuccessful cardiopulmonary resuscitation in simulation. Some believe that it could cause undue stress and interfere with learning.1 Others argue that death after resuscitation is expected and that successful resuscitation in every simulation distorts...

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