Crit Care Nurse. 2025 Dec 1;45(6):42-49. doi: 10.4037/ccn2025644.

BACKGROUND: Open chest emergencies are high-risk, low-frequency events. Resternotomy procedures should be performed within 5 minutes of a suspected complication. The inability to recognize a complication can delay meeting the 5-minute metric.

OBJECTIVES: To improve nurses’ recognition of cardiac tamponade and awareness of equipment needed for resternotomy and to decrease response time from start of cardiac arrest to resternotomy.

METHODS: In coordination with key stakeholders, the nursing professional development specialist created a 4-hour multimodal education program that included classroom engagement, deliberate practice, and a high-fidelity simulation with detailed prebriefing and debriefing. In 2023 the course was increased to 8 hours to allow for a repeat of the simulation.

RESULTS: A total of 444 nurses participated. The mean (SD) setup time in preparation for sternotomy in 2021 was 311.2 (101.7) seconds, or 5.2 minutes; in 2022 was 323.8 (183.7) seconds, or 5.4 minutes; and in 2023 (after the repeated simulation was added to the course) was 254.8 (170.4) seconds, or 4.2 minutes, which was less than the 5-minute metric.

CONCLUSIONS: After attending the course, nurses’ response time during simulation of an open chest emergency improved.

PubMed:41319984 | DOI:10.4037/ccn2025644