Effects of ECMO Simulations and Protocols on Patient Safety

Abstract

The use of extracorporeal membrane oxygenation (ECMO) has greatly increased over the years; however, the survival rate is only above 56%. There has been a drastic increase in ECMO centers and cases. ECMO has become a popular therapy route for patients with respiratory and cardiac complications; however, patient safety is a major concern. Perfusion and non-perfusion students from the University of Nebraska Medical Center were recruited to participate in three simulation trials. The trials consisted of five different tasks that are required for managing or preventing catastrophic events on ECMO. Students were evaluated for the time it took to complete each task, number of errors made, and protocol referencing. The data indicated that there was a decrease in time for the 1st vs. 2nd trial (p= .02) for perfusion students and a decrease from the 1st to 3rd trial (p= .001) for the circuit set-up simulation. There was a decrease in priming time from the 1st to 3rd trial (p= .02) and for the pump change (p= .0098) for the perfusion students as well. The non-perfusion students had a significant decrease in time for the circuit set-up in the 1st vs. 2nd (p= .004) and 1st vs. 3rd trial (p= .002). There was a decrease in time for priming (.004), pump change (p= .002), tubing change (p= .0098), and errors during the tubing change (p= .02) in the non-perfusion students. Both groups felt more confident after the simulations and the non-perfusion students specifically felt like they were more familiar with the purpose of ECMO after the simulation. ECMO simulations and protocols may improve patient safety by strengthening the skills needed for rapid management, fewer errors, and higher levels of confidence during the management of ECMO and catastrophic events.