Purpose: The aim of this study was to examine the effect of repeated simulation and role rotation in a cardiac arrest simulation on learning immersion, learning confidence, and simulation satisfaction. Methods: This study was the descriptive survey and 199 nursing students completed a cardiac arrest simulation-based education program developed by the researcher. Participants repeated the simulation 3 times. Data were analyzed using time series, ANOVA, t-test with SPSS 21.0 program. Results: Over than 2 times was effective frequency of repetition of simulation. There were no differences in learning immersion, learning confidence and satisfaction after simulation due to rotation. Additionally, there were no differences in satisfaction after simulation. However, participants in the lead nursing role in simulation had less learning immersion and learning confidence compared to those not in the lead role. Conclusion: The results indicate that repeted use of the cardiac arrest simulation improved clinical practice; however, role rotation did not impact learning immersion or learning confidence. Even though there was no effect of role rotation, the results did indicate that experience as a leader in simulation is associated with less learning immersion and confidence. These results suggest the need to carefully debrief the lead nursing student. Further, in order to prevent nursing instructor burn-out and encourage participation of students in learning, future work should examine increased repetition frequency.

The aim of this study is to confirm the importance of a more immediate advanced cardiac life support (ACLS) through a comparative analysis of the results of cardiopulmonary resuscitation (CPR) according to the occurrence place of cardiac arrest in tertiary emergency department. The subjects were 493 patients who had received CPR in Chosun university, Emergency Medical Department, between April 2013 and March 2015. The subjects were categorized into three groups according to the occurrence place of cardiac arrest: pre-hospital, in-emergency room, and in-ward. We conducted a clinical analysis of the results. During the period, 493 cardiac arrest patients underwent CPR, 63 patients (12.8%) were discharged alive and 41 patients (8.3%) got a good score on the cerebral performance category (CPC). Concerned occurrence place of cardiac arrest, 11.3% (16 patients) of the in-emergency room group (total 288 patients) were discharged alive. Also, 9.4% (27 patients) of the In-emergency room group got a good score on the CPC. In the other two-group cases, 7.1% (10 patients) of pre-hospital group (total 141 patients) and 6,2% (4 patients) of in-ward group (total 64 patients) got a good score on the CPC. These results indicate that both the rates of alive discharge and a good CPC score of the in-emergency room group are higher than in out-of-emergency room. This difference might be due to the fact that patients could get the more immediate ACLS by emergency medicine doctors if cardiac arrest occurs in emergency room than other places.

The purpose of this research is to compare between past and present resuscitation outcome of cardiac arrest patients in one emergency department. A clinical analysis of 429 cases of CPR performed in one emergency department from April 2013 to March 2015 was conducted. Then we compared this with previous paper that were written in same emergency department in 2004. During the period, 429 patients received resuscitations. Between the two studies, all patients under CPR were increased 2.27 times (94.33 pts/years to 214.5 pts/years). As the cause of cardiac arrest, traumatic cardiac arrest increased to 30.1% form 24.1%. Cardiogenic cardiac arrest showed highest survival rate in two studies, and the ratio was increased from 6.8% to 15.2%. VF/VT showed highest survival rate in two studies, and the ratio was increased from 8.8% to 20.7%. In this study, At least who once became ROSC patients was 260 people (60.6%), permanent surviving patient was 34 people (7.93 %), patients with CPC score 1-2 was 26 people (6.06%). The survival rate of patients with cardiac arrest has increased compared to the past. But in-hospital cardiac arrest survival rate is still low so it is necessary to increase the recovery rate of cardiogenic arrest survival rate to increase the permanent survival rate and good prognosis patients.