Tanta University

Faculty of Nursing

Master degree (Administration specialty course)

2021-2022

Training program

Under supervision
Prof Dr/karima El sayed
DR/zohor zakria
DR/seham aly

/Prepared by
Nora Mohamed Hussien
 *Scenario:
Nurse Director in Kafr elshikh university hospital ask staff nurse
about their knowledge and skills about a lot of topics and
procedure in clinical work practice in the hospital.

Questionnaire to assess staff needs

Title need Not need
Glasgow coma scale
Triage in emergency
Conflict and stress management
D C shock procedure
New medical record models
Fall assessment model
Braden assessment model
Critical value
Nursing polices
NSR standard

Training plan for nurses' staff :

Title Implementation Responsible for time Evaluation

implementation
D C shock Pre test Training 25/5 Post test
procedure coordinator to Monitor the
Training on D C 27/5 hand over
Shock procedure record
 and technique
NSR standard Training nurses on Quality 28/5 Post test
NSR standard and coordinator To Review
how applicate to Training 10/6 Application on
the patients coordinator medical record
Head nurses
Conflict and stress Lecture Training 11/6 Take feed back
management Training staff how coordinator To from staff
to deal with stress Nursing 20/6 Monitor
administrator psychological
status

Educational program about D C shock procedure:

The first step in the construction of this program was the
statement of instructional objectives. These objectives were
derived from the assessed need of nurses in the hospital.
Instructional objectives:
The main objective of the program is to improve nursing staff's
knowledge and performance regarding D C shock procedure
Specific objectives
At the end of the program, the nurses should have knowledge
and skills to implement D C shock procedure.
1-Define of D C shock
2-discuss indication of D C shock
3-discuss contra indication of D C shock
4-discuss Preparation before procedure
explain Procedure of D C shock-5
define Post procedure-6
7- discuss Complication of D C shock
Selection and organization of program contents

This content was designed to provide knowledge related to D C

shock procedure.

Selection of teaching method: -

The methods used were lecture, group discussion and work

situations.

Teaching aids:
The teaching aids used for attainment of program objectives
were data show, handouts, poster and brochure

Implementation of program:
- The study was carried on 10 nursing staff from internal
department and should be take permission from nurse director
and head nurse of these departments about program.

Session in this program divided into 2 session . The program

time was 2hours. One session every day for 2days, every session
1 hour, and program was conducted for nursing staff at their
work in hospital. They preferred to start session at 12pm – 1pm
as it was the most suitable time for them after finishing
necessary work. The nurses were informed about objectives of
program.

Session one

Session one objective:

At the end of the 1st session, the nurses will be able to
understand th D C shock procedure.
Intended learning outcome of the session.
A- Knowledge and understanding:
1-Define D C shock
2-enumerate indication of D C shock
3-enumerate contraindication of D C shock
B- Intellectual capabilities:
1-discuss preparation before procedure
C- Teaching style
Establish different learning and teaching styles during teaching.
-trainer - nurse centered
 - Encourage collaboration

D C shock procedure

Session one: 1hours

Content Time Teaching and Teaching Responsib
frame learning aids le for
(minut method implement
e)
Establishment of social 5 Training
coordinator
relationship and well coming
Nursing
the group manager

Pre test : 10 Group Hand out Training

Ask staff about : discussion Data coordinator
What is your information about D simulation show
C shock? Example
When its used and when not used?
from
what is risks from misuse ? 20
work
A- Knowledge and
understanding
1-Define D C shock .
2-enumerate indication of D
C shock .
3-enumerate contraindication
of D C shock .
Break 5
B- Intellectual capabilities 10 Group Hand out Training
coordinator
1- Define preparation discussion Data
Nursing
before procedure Simulation show manager
Example
from
work
C- teaching style 10 Group Data Training
coordinator
Establish different learning discussion show
and teaching styles during
teaching.
-trainer - nurse centered
- Encourage collaboration
-nurse – centered
Review and summary 5
The content: -
What is a DC shock?
A direct current cardio version is a procedure, which uses a defibrillator
(a medical device) to deliver a controlled electric shock to your heart in
order to try and return your heart rhythm (or beat) to normal
Indication:
Atrial fibrillation and atrial flutter-
Ventricular and supraventricular tachycardia-
-Other rhythm disorders
:Contra indication o

-No clear onset of the history of palpitations o

Previous paroxysms of tachyarrhythmia and not on - o

anticoagulation

Known atrial thrombus- o

:Before procedure

Gain written consent from the patient if alert --

about
Risks of sedation; pain (musculoskeletal or minor skin injury);
failure (approx. 20%); stroke (<1%); bradycardia
Ensure the area where de-fibrillator pads are to be placed is --
shaved and dry and that jewelers is removed
Ensure cardiac monitoring is in place-
 -Ensure anesthetist is happy for you to proceed

Session two

Session two objective:

At the end of 2nd session, the nurses will be able to understand
D C shock procedure and technique
Intended learning outcome of the session.
A- Intellectual capabilities
1-discuss procedure of D C shock
B- Knowledge and understanding
Define Post procedure-1
2- Complication of D C shock
C- Teaching style
Establish different learning and teaching styles during teaching.
-trainer - nurse centered

- Encourage collaboration

nurse - centered-

Content Time Teaching and Teaching Responsib

 frame learning aids le for
(minut method implement
e)
Introduction and revision on 5 Training
coordinator
previous session
Nursing
manager

A- Intellectual capabilities 25 Group Hand out Training

1-discuss procedure of D C discussion Data coordinator
shock simulation show
Example
from
work
Break 5
B- Knowledge and 10 Group Hand out Training
coordinator
understanding discussion Data
Nursing
Define Post procedure-1 Simulation show manager
2- Complication of D C shock
Example
from
work
C- teaching style 10 Group Data Training
coordinator
Establish different learning
and teaching styles during discussion show
teaching.
-trainer - nurse centered
- Encourage collaboration
-nurse – centered
Review summary and 5
closing

:The content
: Procedure for DC cardio version -
-Place the defibrillator pads to ensure the current will pass across the
heart.

-This can be in the conventional position, anterio-posterior, postero-

lateral or bi axillary

-Sedation as necessary

-Turn on the defibrillator and press ‘Sync’

-Check your trusts’ policy on level of energy but a rough guide is

100J,150J, 200J

-Charge the defibrillator ensuring everyone is clear including the oxygen

-Deliver a safe shock as per ALS guidelines

-Confirm presence of a pulse

-Check the monitor for sinus rhythm

Two further shocks (escalating energy) can be given if necessary.

:Post procedure
Continue cardiac monitoring-
Post-procedure observations-
Request cardiology review for further investigation, medication -
and follow up
- :Complication
Potential complications include ventricular fibrillation due to
general anesthesia or
lack of synchronization between the direct current (DC) shock -
,and the QRS complex
thromboembolism due to insufficient anticoagulant therapy, -
non-sustained VT, atrial arrhythmia, heart block, bradycardia,
transient left bundle branch
:Post test
: Ask staff about your information such as
What is your information about D C shock?

When its used and when not used?

What is risks from misuse?

?What is the procedure of D C shock

:Evaluation
.After two session ask staff nurse about
Your opinion in the learning and training program and if found any
challenges during session and any comments