Dedicated chest compressor team: A quality improvement initiative to improve chest compression performance at in-hospital cardiac arrest events through quarterly training

专门的胸外按压团队:一项旨在通过季度培训提高院内心脏骤停事件中胸外按压效果的质量改进计划

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Abstract

BACKGROUND: High-quality cardiopulmonary resuscitation (CPR) is foundational to all resuscitative efforts. Spaced practice improves learners' skill retention. We evaluated the implementation of a quarterly CPR curriculum and skills training program for a dedicated chest compressor team to improve the quality of CPR performed during in-hospital cardiac arrest (IHCA) events and its impact on patient survival of event. METHODS: Baseline observations on CPR performance within the hospital were collected in October 2018. The CPR quarterly training program was implemented in November 2018. Training included use of high-fidelity simulation manikins and team members received real-time feedback scores related to compression rate, depth and recoil. High-quality CPR scores were set at ≥ 70%. Yearly IHCA event survival data was examined in relation to the implementation of training. RESULTS: Quarterly CPR training of the team led to retention of CPR skills (chest compression rate, depth, and recoil). The team's initial CPR training performance average score was 49.1%, increasing to 80.3%, with 95% (n = 37) of participants achieving a higher score after feedback during their initial training. A two-sample t-test was used for numerical data and chi-square was used for proportional data analysis. The survival of event prior to this training was 61.0% January-October 2018. Post -training, event survival rose to 73.5% (p-value 0.03) in 2019. CONCLUSION: Implementation of a team that attends quarterly CPR training with a high-fidelity simulation manikin is attainable. This training resulted in improved CPR quality and benefited IHCA event survival.

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