Patient safety is the most important indicator of quality care in hospitals. The aim of each hospital is to save the critical patient through effective resuscitation and to raise the discharge survival rate of patient after CPR. Previously nursing staffs were unfamiliar to procedure of first aid and were incapable to respond to emergent condition even they had already had training of CPR and ACLS. This research had two stages. Stage one was a qualitative research which included literature review, focus group interview. Data of words and images related to flipped learning and learning effectiveness were collected, analyzed by working group of research. Stage two was a quasi-experimental design which explore the effectiveness and associated factors of flipped education in nursing by comparing two groups before and after. Nursing staffs who worked at internal medicine /surgical ward more than one year in anyone of five reginal hospitals were enrolled in our research. A total of 48 nursing staffs were randomized and separated to experimental and control group.

    The research results reflect (1) After test of capability in emergency nursing care, average score related to ability of cognition in experimental （77.81±10.00）was significantly higher than control group（64.47±13.63, t=5.51, p< .001）. Average score related to maturity of skills in experimental（3.46±0.54）was significantly higher than control group（3.2±0.63, t=1.821, p< .01）. (2). In learning effectiveness of emergency nursing care, average score related to ability of cognition in experimental, after（77.81±10.00）was significantly higher than before（61.46±13.25, t=14.21, p< .001）. Average score related to maturity of skills in experimental, after（3.46±0.56）was significantly higher than before (2.87±0.68, t=4.601, P< .001).( 3 )Two factors were associated with effectiveness of flipped education: In ability of cognition, R square and predictive ability of advanced level was 12%,β=2.739.In maturity of skills, R square and predictive ability of ACLS training was 13%, β=0.331.

    This research had developed structural and effective flipped education. It could raise learning effectiveness of emergency care in nursing staffs at internal medicine /surgical ward if assisted with learning pathway and teaching structure. We suggest nursing teachers should accept training of flipped education before emergency nursing care modular curriculum. Thus, they are able to do self-learning from website by 2 steps,general teaching ability of classroom discussion and skill rehearsal, professional and coaching for teaching ability.