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高质量心肺复苏教练对儿科重症监护病房复苏团队的影响。

Impact of a Quality Cardiopulmonary Resuscitation Coach on Pediatric Intensive Care Unit Resuscitation Teams.

作者信息

McDermott Katie L, Rajzer-Wakeham Kari L, Andres Jennifer M, Yan Ke, Liegl Melodee A, Schindler Christine A

机构信息

Katie L. McDermott is a critical care pediatric nurse practitioner, Children's Wisconsin, Milwaukee/Medical College of Wisconsin, Milwaukee, and part-time nursing faculty, Marquette University, Milwaukee, Wisconsin.

Kari L. Rajzer-Wakeham is a critical care pediatric nurse practitioner, Children's Wisconsin, Milwaukee/Medical College of Wisconsin, Milwaukee.

出版信息

Am J Crit Care. 2025 Jan 1;34(1):21-29. doi: 10.4037/ajcc2025828.

Abstract

BACKGROUND

The quality cardiopulmonary resuscitation (CPR) coach role was developed for hospital-based resuscitation teams. This supplementary team member (CPR coach) provides real-time, verbal feedback on chest compression quality to compressors during a cardiac arrest.

OBJECTIVES

To evaluate the impact of a quality CPR coach training intervention on resuscitation teams, including presence of coaches on teams and physiologic metrics of quality CPR delivery in real compression events.

METHODS

The quality CPR coach curriculum and role implementation were designed and evaluated using a logic model framework. Medical records of patients who had in-unit cardiopulmonary arrests were reviewed retrospectively. Data included physiologic metrics of quality CPR delivery. Analysis included descriptive statistics and comparison of arrest data before and after the intervention.

RESULTS

A total of 79 cardiopulmonary arrests were analyzed: 40 before and 39 after the intervention. Presence of a quality CPR coach on resuscitation teams was more frequent after training, increasing from 35% before the intervention to 72% after (P = .002). No significant difference was found in the frequency of application of Zoll defibrillator pads. Metrics of quality CPR delivery and adherence with American Heart Association recommendations were either unchanged or improved after the intervention.

CONCLUSIONS

The quality CPR coach training intervention significantly increased coach presence on code teams, which was associated with clinically significant improvements in some metrics of quality CPR delivery in real cardiopulmonary arrests.

摘要

背景

高质量心肺复苏(CPR)教练这一角色是为医院的复苏团队设立的。这位辅助团队成员(CPR教练)在心脏骤停期间,就胸部按压质量向按压者提供实时的口头反馈。

目的

评估高质量CPR教练培训干预对复苏团队的影响,包括团队中教练的存在情况以及实际按压事件中高质量CPR实施的生理指标。

方法

使用逻辑模型框架设计并评估高质量CPR教练课程及角色实施情况。对在病房内发生心脏骤停的患者的病历进行回顾性审查。数据包括高质量CPR实施的生理指标。分析包括描述性统计以及干预前后骤停数据的比较。

结果

共分析了79次心脏骤停事件:干预前40次,干预后39次。培训后复苏团队中有高质量CPR教练的情况更为常见,从干预前的35%增至干预后的72%(P = .002)。在使用Zoll除颤器电极片的频率方面未发现显著差异。干预后,高质量CPR实施指标以及遵循美国心脏协会建议的情况要么未变,要么有所改善。

结论

高质量CPR教练培训干预显著增加了急救团队中教练的存在情况,这与实际心肺骤停中高质量CPR实施的某些指标在临床上的显著改善相关。

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