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St Luke's Medical Center

Presentation Notes

Technological Innovations in Care Redesign and Delivery podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.

Abstract

Introduction and Context: Earlier initiation of extracorporeal membrane oxygenation (ECMO) improves survival in cardiogenic shock.  Patients requiring mechanical circulatory support may experience delays in care for up to an hour, as they wait for the shock team to arrive. By leveraging the catheterization (cath) lab nurse and our in-house 24/7 cardiology interdisciplinary team’s availability and expertise, we developed an evidence-based simulation that allows the entire cath lab team to function as the shock team.

Implementation Strategy: Collaborating with the organization’s simulation team, a low-fidelity percutaneous pelvic model was developed to train the team on ECMO cannulation and circuit set-up in a real-world, in-situ environment. Initial feedback led to the adoption of a rapid cycle deliberate practice approach with 3 distinct cycles: real-time feedback, increased hands-on practice, and corrective interventions. Pre-post surveys compared 5-point Likert agreement responses.

Outcomes and Impact: Twelve simulation sessions occurred (Oct-Dec 2024) with 25 nurses and 30 technologists attending, with an average of 9 years in the department. Thirty-five (18 RN, 17 Tech) completed the survey, with a positive increase in agreement from pre-post. Participants self-reported increased understanding related to activating shock team (pre: n= 26, 74%, post: n= 35, 100%). Clinical criteria for ECMO candidates improved from (pre: n= 24, 69%, post n= 34, 97%). Participants increased readiness by knowing where and how to prepare ECMO (pre: n= 28, 80%, post: n= 35, 100%) and comfort setting up ECMO machine independently improved (pre: n= 11, 31%, post: n= 34, 97%).

Insights: The project improved the nurses' understanding and readiness to independently set up a patient on ECMO. Rapid cycle deliberate practice simulation prepares the team in shock roles is a tactic to decrease ECMO initiation delays. Future case study data and application of skills in practice will be evaluated.

Implications: Future case study data and application of skills in practice will be evaluated.

Document Type

Oral/Podium Presentation

Publication Date

11-12-2025


 

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Nov 12th, 12:00 AM

Nurse Initiated Rapid Cycle ECMO Simulation in the Cath Lab

Introduction and Context: Earlier initiation of extracorporeal membrane oxygenation (ECMO) improves survival in cardiogenic shock.  Patients requiring mechanical circulatory support may experience delays in care for up to an hour, as they wait for the shock team to arrive. By leveraging the catheterization (cath) lab nurse and our in-house 24/7 cardiology interdisciplinary team’s availability and expertise, we developed an evidence-based simulation that allows the entire cath lab team to function as the shock team.

Implementation Strategy: Collaborating with the organization’s simulation team, a low-fidelity percutaneous pelvic model was developed to train the team on ECMO cannulation and circuit set-up in a real-world, in-situ environment. Initial feedback led to the adoption of a rapid cycle deliberate practice approach with 3 distinct cycles: real-time feedback, increased hands-on practice, and corrective interventions. Pre-post surveys compared 5-point Likert agreement responses.

Outcomes and Impact: Twelve simulation sessions occurred (Oct-Dec 2024) with 25 nurses and 30 technologists attending, with an average of 9 years in the department. Thirty-five (18 RN, 17 Tech) completed the survey, with a positive increase in agreement from pre-post. Participants self-reported increased understanding related to activating shock team (pre: n= 26, 74%, post: n= 35, 100%). Clinical criteria for ECMO candidates improved from (pre: n= 24, 69%, post n= 34, 97%). Participants increased readiness by knowing where and how to prepare ECMO (pre: n= 28, 80%, post: n= 35, 100%) and comfort setting up ECMO machine independently improved (pre: n= 11, 31%, post: n= 34, 97%).

Insights: The project improved the nurses' understanding and readiness to independently set up a patient on ECMO. Rapid cycle deliberate practice simulation prepares the team in shock roles is a tactic to decrease ECMO initiation delays. Future case study data and application of skills in practice will be evaluated.

Implications: Future case study data and application of skills in practice will be evaluated.

 

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