Authors: (including presenting author): :
Cheng HM(1), Wong SY(1), Wong KW(1), Wan HY(1), Fung SS(1), Wong LY(1)
Affiliation: :
(1)Department of Cardiothoracic Surgery, Queen Mary Hospital
Keyword 1: :
Extracorporeal membrane oxygenation
Keyword 2: :
intensive care nursing
Keyword 3: :
education program
Keyword 4: :
simulation training
Keyword 5: :
competency assessment
Keyword 6: :
percutaneous cannulation
Introduction: :
Extracorporeal membrane oxygenation (ECMO) is a mechanical heart–lung support system for patients with profound cardio-respiratory failure. According to Cardiothoracic Surgery Intensive Care Unit (CTSICU), Queen Mary Hospital (QMH), the number of adult bedside ECMO cannulation rose from 35 to 50 between the 2016-2020 and 2021-2025 periods, marking a 42.9% growth in service utilization. For details, bedside cannulation is known for reducing the time to initiation of therapy and minimizing the hazards associated with patient transport. Yet, it is inherently complex and high-stakes, requiring a dedicated team response within a narrow window of time. In view of the increasing demand, a structured training program was implemented in QMH CTSICU to promote procedural efficacy and patient safety by enhancing nurses’ knowledge, skills and confidence in assisting ECMO cannulation events.
Objectives: :
1. To reinforce a consistent and safe nursing practice for assisting percutaneous ECMO cannulation in CTSICU.
2. To enhance CTSICU nurses’ knowledge, technical skills and confidence in assisting percutaneous ECMO cannulation.
Methodology: :
The program comprised a pretest-posttest written assessment, a 45-minute didactic session, a 45-minute water-drill, a skill competency assessment and a post-program survey. The didactic session covered key cognitive domains including role delineation, ECMO set up and operation, cannulation approach and specific nursing considerations. During the water-drill session, participants alternated roles within the team to deepen conceptual understanding and team dynamic. Upon completion of this program, participants’ knowledge and skills were evaluated by a post-written assessment and skill competency assessment respectively. Feedback was collected through a post-program survey to evaluate efficacy of this program by qualitative domains.
Result & Outcome: :
The program was conducted from June to December 2025. 17 registered nurses with at least 3-year of CTSICU experience were recruited. Participant’s knowledge levels in managing percutaneous ECMO cannulation increased significantly from mean score 6.29±1.90 (scale of 0-10) to 7.88±2.15, with significance level at p< 0.05 by two-tailed t-test. In the skill competency assessment, individual performance was evaluated using a validated checklist. The overall compliance rate reached 99.51%, with 100% compliance in critical items. These findings demonstrated that the program effectively strengthened adherence to departmental practice. According to the post-program survey, 94.1% of participants reported greater confidence in assisting percutaneous ECMO cannulation in clinical practice, reflecting a positive impact on their sense of mastery. To conclude, this training program yielded positive outcomes and moving forward, it should be conducted on a regular basis to sustain the quality of ECMO service in QMH CTSICU.
