Rapid ECMO Training for Nurses in Response to the COVID-19 Pandemic

Purpose From March 17th to April 29th, our ECMO Program placed 30 adult patients on venovenous extracorporeal membrane oxygenation (VV-ECMO) for management of coronavirus disease 2019 (COVID-19). This acute increase in volume placed a strain on our available ECMO-competent nursing staff. Although perfusionists function as our ECMO specialists, our critical care nurses provide continuous circuit monitoring and respond to emergencies. Because of the need to increase the number of ECMO-competent nurses, on March 27th a focused, two-hour COVID-ECMO training course was implemented. Methods We retrospectively reviewed the number of ECMO care hours provided by our nursing staff and separated the nursing staff into two cohorts. Group A consisted of nurses who had undergone ECMO training prior to the pandemic (n=126). Group B consisted of nurses whose initial ECMO training occurred during the pandemic (N=145). We then compared the number of nursing hours provided by each cohort before and after training. Results From March 27th to May 4th, 145 nurses completed training, increasing our total number of ECMO-competent nurses from 126 to 271 (115% increase). From March 17th to June 30th, 20,677 ECMO care hours were provided. Pre-training, all 634 care hours were 100% provided by Group A nurses. Post-training, 20,043 care hours were provided, consisting of 39% Group A nursing coverage and 61% Group B nursing coverage. There were no differences in nursing related ECMO-emergencies between the two groups. At the conclusion of the surge, 28 out of 30 (93%) patients survived ECMO and 26 out of 29 patients (90%) survived to hospital discharge. One patient has a pending hospital disposition. Conclusion Rapid implementation of an abbreviated ECMO education program for nurses is feasible. It met the time-sensitive needs of the COVID-19 pandemic and provided safe nursing coverage to patients requiring ECMO.