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专业胸部按压团队:一项通过季度培训提高院内心脏骤停事件中胸部按压质量的质量改进举措。

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

作者信息

O'Leary Amanda, Butler Polly, Fine Jeffrey R

机构信息

University of California Davis Medical Center, Patient Care Resources, 2335 Stockton Blvd, Suite 3011, Sacramento, CA 95817, United States.

University of California Davis Medical Center, Center for Professional Practice of Nursing, 4900 Broadway Suite 1630, Sacramento, CA 95820, United States.

出版信息

Resusc Plus. 2023 Jan 31;13:100361. doi: 10.1016/j.resplu.2023.100361. eCollection 2023 Mar.

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.

摘要

背景

高质量心肺复苏(CPR)是所有复苏努力的基础。间隔练习可提高学习者的技能保留率。我们评估了为专门的胸外按压团队实施的季度CPR课程和技能培训计划,以提高在院内心脏骤停(IHCA)事件期间进行的CPR质量及其对事件患者生存率的影响。

方法

2018年10月收集了医院内CPR表现的基线观察数据。CPR季度培训计划于2018年11月实施。培训包括使用高仿真模拟人,团队成员收到与按压速率、深度和回弹相关的实时反馈分数。高质量CPR分数设定为≥70%。检查了与培训实施相关的年度IHCA事件生存数据。

结果

对该团队进行的季度CPR培训导致CPR技能(胸外按压速率、深度和回弹)得以保留。该团队最初的CPR培训表现平均分数为49.1%,提高到了80.3%,95%(n = 37)的参与者在初始培训期间收到反馈后分数更高。对数值数据使用双样本t检验,对比例数据使用卡方检验。2018年1月至10月此培训前事件的生存率为61.0%。培训后,2019年事件生存率升至73.5%(p值0.03)。

结论

组建一个每季度使用高仿真模拟人参加CPR培训的团队是可行的。此培训提高了CPR质量,并使IHCA事件生存率受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e72c/9926014/2930481c0f46/gr1.jpg

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