Simulation Innovation
Story 164

Picture innovation in healthcare and most people would likely think of automation, surgical robots and new technologies that perhaps can’t even be fathomed.  

At Adventist Health St. Helena, the latest example of healthcare innovation is slightly less flashy, but every bit as effective.  

It features a CPR training torso, wires, plastic plates purchased at the hardware store, a foam stress ball and a tenacious nurse educator eager to support her colleagues and improve outcomes for cardiac patients. 

“A large portion of the patients who are treated in the Intensive Care Unit in St. Helena are cardiac surgery patients,” said ICU Clinical Education Specialist Sarah Spence, adding that ICU nurses go through rigorous additional training to prepare for unique challenges patients may experience after undergoing cardiac surgery.  

But as new nurses have joined the unique Cardiovascular ICU (CVICU), they expressed a desire for more in-depth training on how to manage post-surgical complications specific to cardiac patients.  

Like, for example, how they might respond to a cardiac arrest with a post-operative patient who has just had their sternum cut open and then wired shut, and for whom traditional chest compressions are not an option.  

Enter the emergency sternotomy, and Spence’s unique training program.  

To prepare nurses in the CVICU with hands-on experience for this procedure, she wanted to create a training dummy, but had to get creative. She purchased an old CPR training torso and went to work on it with a pair of shellfish shears, opening the chest.  

That’s when she realized that, unlike a real patient, her dummy didn’t have a breastplate. A quick trip to the hardware store would solve that. She found a piece of one-quarter inch plastic and sawed it down the middle – something Spence said was the most challenging part of this project. Once she wired it back together, it simulated a rewired sternum.  

And, of course, no cardiac training dummy is complete without a heart. Spence embedded a foam, heart-shaped stress ball just past the sternum before she sewed up her training torso.  

The result? A low-cost, highly-effective training dummy that gives nurses hands-on experience to improve muscle memory and knowledge retention.  

“The best part was everyone's excitement and enjoyment during the simulation practice,” Spence said.  

Those who took part said they felt more prepared for an emergency after the practice and doctors were impressed with the realistic feeling of the wire removal process.  

Spence, who so enjoyed working at Adventist Health St. Helena as a travel nurse and left her bedside role in 2021 to become a full-time nurse educator, said that the role has offered her both flexibility and fulfillment.  

“I get the pleasure of watching the nurses I work with grow in their clinical practice and the ability to help them progress along the way,” Spence said. “I love my job more than I ever could have imagined.”