Biomedical subjects

M E Mancini

Publications and source records attributed to M E Mancini.

23 records · Page 2Linked to original sources

PubMed1986

Retention of cardiopulmonary resuscitation skills by physicians, registered nurses, and the general public.

To evaluate retention of CPR skills by medical residents (MDs), registered nurses (RNs), we tested single-rescuer CPR skills of 21 MDs, 17 RNs, and 21 laypersons using recording manikin and American Heart Association criteria. All study participants had been trained from 4 to 12 months before testing. No MD or RN and only one layperson performed each step correctly and in proper sequence. If calls for assistance were eliminated, one additional layperson, two MDs, and two RNs performed correctly. There were no significant differences between the MDs and RNs. MDs and RNs did better (p less than .01) in assessment compared to laypersons, but some individuals in each group initiated ventilations and compressions without assessing need. There was no difference in the ability to perform ventilations; all three groups did poorly. MDs and RNs performed compression skills better than laypersons (p less than .01), but all had difficulty with rate and depth of compressions. Moreover, only one-third of the general public demonstrated correct hand placement. Despite more training and experience, MD and RN performance was comparable to layperson performance. These data suggest that improving basic life-support skills could save more lives.

Clinical Competence↗

PubMed1985

The effect of time since training on house officers' retention of cardiopulmonary resuscitation skills.

Currently, the American Heart Association (AHA) recommends that physicians be certified in cardiopulmonary resuscitation (CPR) every two years. This study was undertaken to determine the effects of time since training on retention of CPR skills of physicians and to identify at what point performance deteriorates to a level requiring retraining with supervised practice. The physicians' performance of CPR one year or less after training was compared with that of more than one year after training. Thirty-three medical residents who had been taught CPR by the same instructor were tested without warning for one-person CPR on a recording mannikin. Performance was evaluated according to AHA Heartsaver criteria. The data were analyzed by organizing all CPR steps or behavioral objectives into three categories: assessment, skills (which included ventilation and compression), and sequence (which included calls for assistance). The data suggest that the knowledge of CPR sequence remains stable and that assessment improves while skill performance deteriorates after one year. This apparent contradiction in overall CPR performance may relate to the effect of experience. Assessment may improve because of involvement in actual resuscitations in the hospital. Deterioration of skills may reflect the fact that senior residents do not actually perform CPR, but become team leaders and thereby lose their skills, or that poor performance is not corrected in actual "code" situations. If a two-year certification standard is maintained, CPR skill testing at least every 12 months should be considered. If skills have deteriorated, hands-on-practice should be undertaken at that time.

Certification↗

PubMed1985

Can better basic and advanced cardiac life support improve outcome from cardiac arrest?

The effect of basic and advanced cardiac life support (BLS and ACLS) on long-term survival is dependent upon both the response time and the quality of intervention. Retention research using the results of classroom testing as indirect indicators has shown that performance of BLS and ACLS skills is poor. This suggests that BLS and ACLS courses do not teach the knowledge and skills well, the information is too difficult to retain, testing procedures are faulty, and/or the performance standards are unrealistic. To maximize the likelihood of successful resuscitation from cardiac arrest, we propose the following: (a) simplify the BLS procedures; (b) simplify the BLS and ACLS curricula; (c) simplify teaching strategies; (d) simplify testing based on what steps are required to sustain life; (e) define objective criteria for knowledge acquisition and skill performance; (f) base refresher training on diagnosed deficiencies and evaluate innovative ways to improve retention; (g) develop a resuscitation record to provide accurate documentation of patient status, dysrhythmias, therapy, and responses to therapy; (h) develop a process evaluation tool to evaluate individual and group performances during actual resuscitation; and (i) form an international consortium of BLS and ACLS investigators.

Animals↗

PubMedDate not supplied

Developing a culturally competent work force: an opportunity for collaboration.

This article describes a collaborative project formed between three major community systems--education, health care, and the business sector--to respond to the specialized cultural needs of a growing Hispanic population in a large public health care system in Dallas, TX. Two specific strategies, short-term cultural immersion and the development of a nurse exchange program with a "sister" hospital in Mexico, assist health care personnel to learn the language and the culture of Mexico. Findings from process evaluation suggest that these initiatives are essential and beneficial to changing individual views and developing knowledge and skills. Community partnerships requiring a significant commitment to a continuum of efforts from top administrative levels to the individual level facilitate institutional responses to the challenge of developing a culturally skilled health work force.

Community-Institutional Relations↗

PubMedDate not supplied

Patient-focused care: a response to the healthcare crisis.

During this time of major challenges and transitions in the healthcare industry, as both healthcare professionals and consumers, nurses are in a pivotal position to become active, informed advocates for reasonable, rational changes within a system in which we have a truly unique perspective. In this environment, it is critical that nurses understand the need for change so that we can critically analyze work redesign initiatives for their likelihood to positively or negatively impact the healthcare system at a global or local level. It will then be possible to explore the transformation of the healthcare delivery system, the concept of patient-focused care, and the impact on the healthcare workforce of the future with particular attention to the practice of intravenous nursing.

Clinical Competence↗