J Emerg Nurs. 2022 Mar;48(2):224-232.e8. doi: 10.1016/j.jen.2021.11.005.
High-quality cardiopulmonary resuscitation is foundational to cardiac arrest care. Visual feedback devices can improve chest compression quality, but are infrequently used. Quality improvement data were examined to determine whether handheld visual feedback and backboard use improved chest compression quality, whether resuscitation team size affected resuscitation indicators, and whether feedback sources are comparable.
From August 2019 to December 2020, data from 50 resuscitations were collected using a handheld device (n = 35), defibrillator (n = 23), and surveys (n = 35) and shared with providers. Aggregated and individual case data, along with education and research, were distributed to staff as quality improvement measures.
The mean duration of resuscitation was 1080 compressions (SD = 858); there were no differences in the durations of resuscitations that did or did not use handheld feedback; 50% of resuscitations used handheld feedback and had more compressions at target rate (74.68% vs 42.18%, t = 2.99, P = .007). Moreover, 25% of resuscitations used backboards; these had more chest compressions at target depth (72.92% vs 48.73%, t = 2.08, P = .048). Team size was not associated with duration of resuscitation or chest compressions quality. There was no improvement in other quality indicators (leadership, family presence, or debriefing) during the data collection period. Feedback sources (defibrillator and feedback device) had good agreement and correlation (r = 0.77, P = .01).
Incorporating handheld feedback and backboards improved chest compressions quality. Further work to improve the frequency of device use and to examine their relationship to patient-specific outcomes is needed. Study is needed to find interventions that improve other teamwork metrics, inclusion of family during the resuscitation, referral for tissue donation, and rates of postevent debriefing.
高质量的心肺复苏术是心脏骤停治疗的基础。可视反馈设备可以提高胸外按压质量，但使用频率不高。本研究通过质量改进数据来确定手持式视觉反馈和背板的使用是否能提高胸外按压质量，复苏团队的规模是否会影响复苏指标，以及反馈源是否具有可比性。
2019 年 8 月至 2020 年 12 月，使用手持式设备（n=35）、除颤器（n=23）和问卷调查（n=35）收集了 50 例复苏的数据，并与提供者共享。汇总和个别病例数据，以及教育和研究，作为质量改进措施分发给工作人员。
复苏的平均持续时间为 1080 次按压（SD=858）；使用或不使用手持式反馈的复苏持续时间没有差异；50%的复苏使用了手持式反馈，目标按压频率更高（74.68% vs 42.18%，t=2.99，P=0.007）。此外，25%的复苏使用了背板；这些背板的按压深度更接近目标（72.92% vs 48.73%，t=2.08，P=0.048）。团队规模与复苏持续时间或胸外按压质量无关。在数据收集期间，其他质量指标（领导力、家属在场和情况汇报）没有改善。反馈源（除颤器和反馈设备）具有良好的一致性和相关性（r=0.77，P=0.01）。
纳入手持式反馈和背板可提高胸外按压质量。需要进一步的工作来提高设备使用频率，并研究它们与患者特定结局的关系。需要研究干预措施，以提高其他团队工作指标、复苏期间家属的参与、组织器官捐献以及事后情况汇报的频率。
