AED EDUCATION 1

AED Education for Staff

Sarah Peterson

Department of Nursing, Viterbo University

NURS 413: Public Health Nursing

Kevin Koch, Clinical Instructor

March 1, 2024
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INTRODUCTION

A sudden cardiac arrest can occur at any time. The purpose of this paper and community

project is to educate school staff on how to respond to a sudden cardiac arrest event with an

automated external defibrillator (AED). This paper will specifically target educators and support

staff within the Tomah School Middle School. The intervention to be used in this project will be

the creation of an informational PowerPoint to help increase awareness of sudden cardiac arrest,

how to respond to a sudden cardiac arrest, the number to call in an emergency, and how to use an

AED. The PowerPoint will be presented to educators and support staff in a group setting.

ASSESSMENT OF COMMUNITY AND TARGET POPULATION

The community assessment for this project was conducted in Monroe County, Wisconsin,

the City of Tomah, and the Tomah School District. Monroe County is considered a rural area,

with over half of the population living in a low-density area. The population of Monroe County

is 46, 274 people, and 24.8% of the population is under the age of 18 (United States Census

Bureau, 2022). The three largest cities in Monroe County are Sparta, Tomah, and Cashton

(World Population View, 2024). Within Monroe County, Fort McCoy, a United States Military

Base is located. The Median household income is $66,451 for Monroe County. Around 9.2% of

those residing within Monroe County are uninsured (City-Data, 2024).

While completing my Windshield survey of Tomah, I made several observations that

support the need for my intervention. First, I noted several fast-food restaurants that were being

used frequently throughout the day. According to City Data, there are 10 fast food restaurants in

Tomah. The obesity rate in Wisconsin is 27.5%, which is higher than the nation’s average of

27.1% (City-Data, 2024).

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The Tomah Public School District is made up of 13 different schools with students from

Monroe, Jackson, and Juneau counties. There are about 3,000 students in the district from

preschool to 12th grade (Lorenz, 2024), with two school nurses in the district. The Tomah

School District employees around 546 people (Lorenz, 2024).

My target population for this project is Tomah Middle School staff, which includes

teachers and administrative personnel. The Tomah Middle School serves grades sixth through

eighth and has approximately 98 staff members (Lorenz, 2024). A few years ago, a Tomah

School District staff member died from sudden cardiac arrest. I have chosen staff members as my

target population because they can act on the scene regardless of whether the victim is a student

or an adult. Regarding health, schoolteachers are more prone to heart disease as a result of work-

related stress (Familoni et al., 2021). Stress may lead to high blood pressure, which increases an

individual's risk for heart attack and stroke. In addition, stress can contribute to unhealthy

activities such as overeating, smoking, or lack of physical activity. Thus, contributing to an

increased risk for cardiovascular disease (American Heart Association, 2020).

The Tomah School District is currently staffed with two registered nurses who are

responsible for providing care for the 13 schools within the district and who would be unable to

respond in a reasonable time to a cardiac event due to the distance and location of their offices to

most of the schools in the district.

Additionally, the Tomah School District is currently working on becoming Project

ADAM certified to ensure schools are prepared for and respond to sudden cardiac arrest with the

implementation of AEDs within every district building. Thus, there is a critical need to provide

AED training to the staff in closer proximity and working in the middle school.
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ASSESSMENT AND ANALYSIS OF PRIMARY HEALTH NEEDS OF THE TARGET

POPULATION

The three primary health needs of Tomah Middle School staff include hypertension,

obesity, and mental health resources. Teachers are at a high risk for hypertension due to job

responsibility for children and emotional strain. Hypertension is one of the most common

diseases in the United States and is a preventable cause of death. Pre-hypertension and

hypertension among teachers are a strong modifiable risk factor (Ibrahim et al., 2008). Those

with hypertension have an increased risk of developing obesity.

Around 85% of teachers report abdominal obesity (Lizana et al., 2019). The chronic

conditions of hypertension and obesity affect the mental health of teachers. In addition, teachers

are exposed to many job stressors increasing their risk of adverse mental health effects

(Schonfeld, 2017). Based on my windshield survey, there is a need for mental health resources

within the community of Tomah, Wisconsin. The prevalence of burnout ranged from “25.12% to

74%, stress ranged from 8.3% to 87.1%, depression ranged from 4% to 77%, and anxiety ranged

from 38% to 41.2%.” Teaching is a challenging profession, and several factors correlate with

stress, anxiety, and burnout among teachers (Belinda, et al., 2022). Thus, leading to overall

health challenges for teachers. Mental health challenges, such as depression can increase the risk

of heart disease and stroke (Centers for Disease Control and Prevention, 2023).

Based on these needs, my priority health need for middle school staff members is

education. Staff members with hypertension and obesity are at an increased risk for heart

problems (Centers for Disease Control and Prevention, 2023). Due to knowing the risk factors of

heart problems, there is a need for AEDs within school buildings. Sudden cardiac arrest can

affect anyone and staff within the Tomah Middle School need to know how to respond.
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Currently, the Tomah School District is working on becoming Project ADAM certified to

ensure schools are prepared for and respond to sudden cardiac arrest. According to the school

nurse, to become Project ADAM certified schools must complete a checklist demonstrating their

preparedness. The checklist for AEDs includes equipment locations in under 3 minutes to an

unresponsive victim, clear signage, a performance readiness check for an AED each month, and

a first responder kit near or attached to an AED. There must be a cardiac emergency response

team. This consists of a CPR site coordinator to oversee the activities and training (Lorenz,

2024).

The objective is to create a Cardiac Emergency Response Team comprised of 10% of

staff (Reference). The Cardiac Emergency Response Plan is reviewed annually by the school

nurse. There will be a cardiac communication code that will be utilized to notify responders there

is an event to respond to. Each staff member who is a part of the Cardiac Emergency Response

Team must carry a communication device with them throughout the day. Local emergency

medical services, such as the Police Department, Fire Department, and Ambulance Service must

be notified of the CPR-AED program and shared with outside groups or organizations that utilize

school facilities. There must be documented and continued training and education once a year by

the school nurse. CPR-AED training is updated every two years. All staff must know where to

locate and how to access the AEDs. All faculty and staff must complete annual training on

sudden cardiac awareness. This training is in person and is led by the school nurse. Lastly, a

cardiac emergency response drill must be completed at least once a year. Staff certification will

be managed by the school nurse. (Project ADAM, 2021). From this knowledge, we can develop

the expected outcomes for the project.

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DEVELOPMENT OF EXPECTED OUTCOMES FOR THE PROJECT

My expected outcome for this community assessment project is that the Tomah Middle

School staff will become more educated on how to recognize the signs of sudden cardiac arrest,

how to use an AED in cases of emergency, and who to call to activate a response from the

Emergency Management System (EMS).

My short-term goal is by the end of the educational teaching 70 percent of staff will be

able to recognize signs of cardiac arrest, locate and utilize AEDs around the building, and 100

percent will know the number they are supposed to call in an emergency. This short-term goal

will allow staff to become more prepared for emergency response.

My long-term goal is that within 90 days, 60 percent of Tomah Middle School staff will

be able to recognize signs of cardiac arrest, locate and utilize an AED and 100 percent will know

the number they are supposed to call in an emergency.

PRIORITY INTERVENTION THAT WILL IMPROVE THE HEALTH OF THE

POPULATION

My priority intervention for my target population of middle school staff is to provide an

educational and interactive PowerPoint presentation related to signs of cardiac arrest and how to

respond to a fellow staff member or adolescent as quickly as possible. This presentation will

improve the knowledge of locating and using an AED, educate staff on how to properly assemble

and apply the components of the AED, and ensure staff obtain the skills necessary in recognizing

signs of cardiac arrest and other resources that are available to them. Staff must know how to

locate and understand how to use an AED. The likelihood of surviving a sudden cardiac arrest is
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greatly increased if a shock is delivered to the cardiac victim within two to three minutes of a

collapse (Project Adam, 2021).

PowerPoint allows creators to present information in a multimodal approach through

various colors, images, and videos to enhance teaching effectiveness. According to Patil and

Jadhav, the utilization of PowerPoint presentations enhances students understanding than more

traditional methods. In addition, the test performance of students was better. In conclusion,

PowerPoint presentations are an excellent method for teaching and learning (2021).

I will begin my presentation by discussing the importance of AEDs. Schools are a

community gathering point for sporting events, band performances, and choir performances.

Based on our knowledge of the community health needs we can recognize the importance of

having an accessible AED within the school. I will next review the warning signs and symptoms

of cardiac arrest. Some warning signs of cardiac arrest include fainting or dizziness with

exercise, excessive fatigue, shortness of breath with exercise, and chest pain or chest discomfort

with exercise. Symptoms that require immediate intervention include sudden collapse, no pulse,

no breathing, and loss of consciousness (Children’s Hospital of Philadelphia, 2015).

After reviewing the warning signs and symptoms, I will proceed with a demonstration of

how to use an AED. This will be a hands-on demonstration to ensure everyone feels comfortable

and safe when handling an AED. I will next review the emergency response team four-digit code

to call in the event of a sudden cardiac arrest. Next, there will be a scavenger hunt to locate the

AEDs around the schools. Knowing where to find an AED in the event of an emergency is

extremely valuable information. I will conclude my presentation with a summary of the main

points discussed. I will end with a survey to determine the knowledge that was retained.
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PLAN OF COMMUNICATION WITH TARGET POPULATION

My plan to communicate this information with Tomah Middle School staff is through an

educational learning session. While discussing this project with my nurse preceptor she shared

that a hands-on presentation is the best way to educate Tomah Middle School staff.

A survey allows us to gather large amounts of information. According to Ponto, surveys

are useful to determine if the teaching approach had clear benefits (2015). In addition, evidence-

based demonstrations have shown that full demonstration improves memory for actions.

Furthermore, self-enactment can benefit the verbal recall of instruction sequences by engaging

visuomotor processes to provide support for working memory performance (Allen et al., 2020).

My interactive presentation will create a safe space for School District staff to learn and discuss

their experiences with sudden cardiac arrest and AED use.

Several potential barriers could arise when educating this group of individuals. First, I

am unaware of each staff member's personal experience with sudden cardiac arrest. This topic

can be difficult to discuss due to personal experiences. Second, many staff members have

reported their concerns about AEDs being dangerous, difficult to use, and overly technical

(Zinckernagel, 2016). This preconceived notion may limit staff members' excitement to learn. In

an emergent situation, fear and panic may overtake an individual ultimately leading them to

forget what to do. In addition, individuals may not want to participate in responding to an

emergent situation. To mitigate these barriers, the Tomah Middle School staff should be

provided with a small card that staff can carry with them at all times. This card will outline the

basic steps of how to respond to a sudden cardiac arrest.

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EVALUATION OF OUTCOMES

Following my presentation, I will evaluate the outcomes of the short-term and long-term

goals I stated. For the short-term goal, I stated that by the end of the educational training, 70

percent of Tomah Middle School staff will be able to recognize sudden cardiac arrest, locate

AEDs around the building, know the number they are supposed to call in an emergency, and

know how to use an AED. I will evaluate this goal by conducting a survey following my

presentation. First, I will ask staff members to demonstrate how to use an AED. Next, I will ask

questions regarding the recognition of a sudden cardiac arrest, the location of the AEDs, and the

number to call in the event of an emergency. I have asked my preceptor to conduct another

survey to see if they can answer the questions correctly.

To evaluate my long-term goal, I have asked my nurse preceptor to help me gather data.

For my long-term goal, within 90 days, 60 percent of Tomah Middle School staff will be able to

locate and utilize an AED and 100 percent will know the number they are supposed to call in an

emergency. I will ask staff members to order the steps of an AED, state the emergency response

number, and give locations of the AEDs within the building.

CONCLUSION

The overall purpose of my community health assessment project is to educate Tomah

Middle School staff on the use of AEDs and provide them with the resources they need to

respond to an emergency. The staff that will be attending this training session work within the

Tomah Middle School building.

I plan to communicate the importance of being able to respond to a cardiac event using an

AED by engaging staff members in an educational presentation and hands-on demonstration. My

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expected outcome is that the Tomah Middle School staff will become more educated on sudden

cardiac arrest and how to use an AED. My short-term goal is by the end of the educational

teaching 70 percent of staff will be able to recognize sudden cardiac arrest, locate AEDs around

building, know the number they are supposed to call in an emergency, and know how to use an

AED. My long-term goal is that within 90 days, 60 percent of Tomah Middle School staff will be

able to locate and utilize an AED and 100 percent will know the number they are supposed to

call in an emergency. My long-term goal evaluation will be completed 90 days following the

presentation by the registered school nurse.

Some barriers to providing this education are personal experiences, preconceived notions

of AED use, fear, forgetting what to do, and not wanting to participate. I plan to mitigate these

barriers by creating a safe environment to discuss how these barriers may limit some individual's

learning experience. In addition, providing education and hands-on demonstration can deepen an

individual’s understanding of how to use an AED and increase the likelihood that they would

respond to an emergency. Lastly, by creating an emergency response team this will ensure

individuals who feel compelled to help with this initiative are able to be a part of it.

Overall, I hope that staff members of the Tomah Middle School can utilize their

resources to respond to a sudden cardiac arrest emergency. It is imperative that staff members

recognize the importance of being prepared to respond to an emergency. Educating and

providing these staff members with resources can save a life.

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Belinda, A., Obuobi-Donkor, G., Burback, L., & Wei, Y. (2022). Stress, burnout, anxiety, and

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