复苏质量改进：提高临床医生的表现。

Resuscitation Quality Improvement: Improving Clinicians' Performance.

机构信息

Sergio Mota is Director, Clinical Research Nursing, Emory University, 21364 Clifton Rd. NE, Atlanta, GA 30322 (

出版信息

AACN Adv Crit Care. 2023 Sep 15;34(3):182-188. doi: 10.4037/aacnacc2023833.

DOI:10.4037/aacnacc2023833

PMID:37644632

Abstract

BACKGROUND

Although cardiopulmonary resuscitation (CPR) renewal occurs every 2 years, quality of performed CPR at the study site was below American Heart Association (AHA) standards. Resuscitation Quality Improvement (RQI) is a new AHA program with the premise that practicing CPR more frequently using audiovisual feedback can improve performance.

OBJECTIVE

To identify whether performance of chest compressions during training reassessments improves with RQI.

METHODS

This study used a preintervention-postintervention design. Critical care nurses from 2 intensive care units performed a baseline round of chest compressions. These baseline data reflected CPR performance with traditional training. The next week, participants completed RQI training. Two weeks after RQI training, participants performed chest compressions. Five weeks after RQI training, participants performed a third round of chest compressions. The compressions performed 2 and 5 weeks after RQI used audiovisual feedback.

RESULTS

Thirty nurses participated. Before intervention, the mean (SD) for overall compression compliance was 32.68% (26.96%), depth was 67.76% (30.15%), and rate was 39.95% (27.41%). The first postintervention (RQI plus 2 weeks) mean (SD) increased to 75.33% (33.70%) for overall compression compliance, 97.43% (12.04%) for depth, and 80.89% (29.35%) for rate. The second postintervention (RQI plus 5 weeks) mean (SD) decreased slightly to 73.16% (36.36%) for overall compression compliance, 96.57% (13.04%) for depth, and 78.75% (31.83%) for rate.

CONCLUSION

Frequent CPR using RQI technology, with its immediate audiovisual feedback, helps maintain skills, which may improve patient outcomes.

摘要

背景

尽管心肺复苏（CPR）每 2 年更新一次，但研究地点的 CPR 质量低于美国心脏协会（AHA）标准。复苏质量改进（RQI）是 AHA 的一个新项目，其前提是使用视听反馈更频繁地练习 CPR 可以提高表现。

目的

确定使用 RQI 进行培训评估时，胸部按压的表现是否有所改善。

方法

本研究采用了预干预后干预设计。来自 2 个重症监护病房的重症监护护士进行了一轮基线胸部按压。这些基线数据反映了传统培训下的 CPR 表现。接下来的一周，参与者完成了 RQI 培训。在 RQI 培训两周后，参与者进行了胸部按压。在 RQI 培训 5 周后，参与者进行了第三轮胸部按压。在 RQI 培训 2 周和 5 周后进行的按压使用了视听反馈。

结果

有 30 名护士参与了研究。干预前，整体按压合格率的平均值（标准差）为 32.68%（26.96%），深度为 67.76%（30.15%），频率为 39.95%（27.41%）。第一次干预后（RQI 加 2 周），整体按压合格率的平均值（标准差）增加到 75.33%（33.70%），深度为 97.43%（12.04%），频率为 80.89%（29.35%）。第二次干预后（RQI 加 5 周），整体按压合格率的平均值（标准差）略有下降至 73.16%（36.36%），深度为 96.57%（13.04%），频率为 78.75%（31.83%）。