1
|
Berger DJ, Lum L, Shercliffe R, Sinz E. Use of High-Fidelity Simulation as an Adjunct to Basic Life Support Training To Promote Team-Based Resuscitation Skills: A Mixed-Methods Pilot Study. Cureus 2024; 16:e62719. [PMID: 39036194 PMCID: PMC11259406 DOI: 10.7759/cureus.62719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction The 2020 American Heart Association's (AHA) Basic Life Support (BLS) curriculum focuses on cardiac arrest resuscitation with one or two rescuers, providing only limited opportunities to develop higher-level skills such as leadership, communication, and debriefing. This mixed-methods pilot study evaluated whether supplementing the traditional Heartcode BLS course with a high-fidelity teamwork simulation session improved mastery of these higher-level skills. Methods Twenty-four first-year medical students completed the pilot training during sessions offered in February and May of 2023. The program included the traditional AHA Heartcode BLS course, which ranges from two to four hours, and includes both online and in-person skills components. This was followed by a 90-minute high-fidelity simulation session consisting of two simulated resuscitations separated by a student-led plus/delta debriefing. Facilitators then debriefed the entire activity. Students completed an anonymous online survey that used a 0-10 slider scale to attribute their perceived proficiency for specific skills to the initial BLS course or the teamwork simulations and provided qualitative feedback. Results Twenty-one students (87.5%) completed the follow-up survey. Students credited their proficiency in technical skills (e.g., "Chest Compressions") to both sessions equally, but proficiency in higher-level skills, such as leadership, communication, and teamwork, was predominantly credited to the simulation. Additionally, students reported that the teamwork simulation promoted realism and increased self-efficacy. Conclusion Team-based resuscitation simulations using high-fidelity equipment augmented the AHA BLS course by promoting perceived competence in team dynamics domains and increasing students' self-efficacy for participating in real hospital-based resuscitations. Studies with larger sample sizes and objective data should be performed, and the use of similar resuscitation simulations or the development of a formal team-based BLS certification course should be considered.
Collapse
Affiliation(s)
- Daniel J Berger
- Emergency & Internal Medicine, Virginia Commonwealth University Health System, Richmond, USA
| | - Lauren Lum
- Resuscitation Sciences Training Center, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Ryan Shercliffe
- Resuscitation Sciences Training Center, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Elizabeth Sinz
- Anesthesiology and Critical Care, West Virginia University, Morgantown, USA
| |
Collapse
|
2
|
Lauridsen KG, Løfgren B, Brogaard L, Paltved C, Hvidman L, Krogh K. Cardiopulmonary Resuscitation Training for Healthcare Professionals: A Scoping Review. Simul Healthc 2022; 17:170-182. [PMID: 34652328 DOI: 10.1097/sih.0000000000000608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY STATEMENT The optimal strategy for training cardiopulmonary resuscitation (CPR) for healthcare professionals remains to be determined. This scoping review aimed to describe the emerging evidence for CPR training for healthcare professionals.We screened 7605 abstracts and included 110 studies in this scoping review on CPR training for healthcare professionals. We assessed the included articles for evidence for the following topics: training duration, retraining intervals, e-learning, virtual reality/augmented reality/gamified learning, instructor-learner ratio, equipment and manikins, other aspects of contextual learning content, feedback devices, and feedback/debriefing. We found emerging evidence supporting the use of low-dose, high-frequency training with e-learning to achieve knowledge, feedback devices to perform high-quality chest compressions, and in situ team simulations with debriefings to improve the performance of provider teams.
Collapse
Affiliation(s)
- Kasper Glerup Lauridsen
- From the Department of Medicine (K.G.L., B.L.), Randers Regional Hospital, Randers; Research Center for Emergency Medicine (K.G.L., B.L., K.K.), Aarhus University Hospital, Aarhus, Denmark; Center for Simulation, Innovation, and Advanced Education (K.G.L.), Children's Hospital of Philadelphia, Philadelphia; Department of Clinical Medicine (B.L.), Aarhus University; Department of Obstetrics and Gynaecology (L.B., L.H.), Aarhus University Hospital; Corporate HR Midtsim (C.P.) Central Denmark Region; and Department of Anesthesiology, Aarhus University Hospital (K.K.), Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | | | | |
Collapse
|
3
|
Young AL, Doughty CB, Williamson KC, Won SK, Rus MC, Villarreal NN, Camp EA, Lemke DS. Workload of learners during simulated paediatric cardiopulmonary resuscitation. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:338-344. [PMID: 35515742 PMCID: PMC8936742 DOI: 10.1136/bmjstel-2020-000652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/03/2022]
Abstract
IntroductionLearner workload during simulated team-based resuscitations is not well understood. In this descriptive study, we measured the workload of learners in different team roles during simulated paediatric cardiopulmonary resuscitation.MethodsPaediatric emergency nurses and paediatric and emergency medicine residents formed teams of four to eight and randomised into roles to participate in simulation-based, paediatric resuscitation. Participant workload was measured using the NASA Task Load Index, which provides an average workload score (from 0 to 100) across six subscores: mental demand, physical demand, temporal demand, performance, frustration and mental effort. Workload is considered low if less than 40, moderate if between 40 and 60 and high if greater than 60.ResultsThere were 210 participants representing 40 simulation teams. 138 residents (66%) and 72 nurses (34%) participated. Team lead reported the highest workload at 65.2±10.0 (p=0.001), while the airway reported the lowest at 53.9±10.8 (p=0.001); team lead had higher scores for all subscores except physical demand. Team lead reported the highest mental demand (p<0.001), while airway reported the lowest. Cardiopulmonary resuscitation coach and first responder reported the highest physical demands (p<0.001), while team lead and nurse recorder reported the lowest (p<0.001).ConclusionsWorkload for learners in paediatric simulated resuscitation teams was moderate to high and varied significantly based on team role. Composition of workload varied significantly by team role. Measuring learner workload during simulated resuscitations allows improved processes and choreography to optimise workload distribution.
Collapse
Affiliation(s)
- Ann L Young
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Cara B Doughty
- Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA
| | - Kaitlin C Williamson
- Pediatrics, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sharon K Won
- Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA
| | - Marideth C Rus
- Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA
| | - Nadia N Villarreal
- Pediatric Emergency Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Elizabeth A Camp
- Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA
| | - Daniel S Lemke
- Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA
| |
Collapse
|
4
|
Lemke DS. Rapid Cycle Deliberate Practice for Pediatric Intern Resuscitation Skills. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:11020. [PMID: 33241116 PMCID: PMC7678026 DOI: 10.15766/mep_2374-8265.11020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION For pediatric interns, it takes deliberate practice to translate the knowledge of what to do in emergencies into the procedural and communication skills required of a team member or team leader. This curriculum taught interns through simulations with rapid cycle deliberate practice (RCDP). This method focused on teaching time-sensitive team-based activities in simulation. The RCDP structure alternated practice with immediate expert feedback. This alternating pattern gave the learner chances to practice the correct way to perform these skills. METHODS The curriculum was developed iteratively based on common gaps in intern skills and knowledge; it was well suited for groups of four to six interns and to be given by one or two instructors over a 6-hour period of time. After an initial warm-up case, a series of simulations used RCDP to move interns through cases focusing on management of respiratory distress, upper airway obstruction, shock, intubation, complications of intubation, and pulseless arrest. Feedback was interspersed throughout the experience with detailed explanations provided as the interns required them to complete the simulations. RESULTS This technique was well received by a group of 81 interns who provided positive feedback on the sessions. In particular, when asked if the course "improved my teamwork and leadership skills" they agreed with a mean score of 4.9 out of 5. DISCUSSION This curriculum taught and integrated the procedural skills, communication skills, and teamwork needed to participate in pediatric resuscitations. The methods described in this curriculum improved confidence of pediatric interns and merits further study.
Collapse
Affiliation(s)
- Daniel S. Lemke
- Associate Professor of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine/Texas Children's Hospital
| |
Collapse
|
5
|
Pujalte-Jesús MJ, Leal-Costa C, Ruzafa-Martínez M, Ramos-Morcillo AJ, Díaz Agea JL. Relief Alternatives during Resuscitation: Instructions to Teach Bystanders. A Randomized Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5495. [PMID: 32751430 PMCID: PMC7432336 DOI: 10.3390/ijerph17155495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
To analyze the quality of resuscitation (CPR) performed by individuals without training after receiving a set of instructions (structured and unstructured/intuitive) from an expert in a simulated context, the specific objective was to design a simple and structured CPR learning method on-site. An experimental study was designed, consisting of two random groups with a post-intervention measurement in which the experimental group (EG) received standardized instructions, and the control group (CG) received intuitive or non-standardized instructions, in a public area simulated scenario. Statistically significant differences were found (p < 0.0001) between the EG and the CG for variables: time needed to give orders, pauses between chest compressions and ventilations, depth, overall score, chest compression score, and chest recoil. The average depth of the EG was 51.1 mm (SD 7.94) and 42.2 mm (SD 12.04) for the CG. The chest recoil median was 86.32% (IQR 62.36, 98.87) for the EG, and 58.3% (IQR 27.46, 84.33) in the CG. The use of a sequence of simple, short and specific orders, together with observation-based learning makes possible the execution of chest compression maneuvers that are very similar to those performed by rescuers, and allows the teaching of the basic notions of ventilation. The structured order method was shown to be an on-site learning opportunity when faced with the need to maintain high-quality CPR in the presence of an expert resuscitator until the arrival of emergency services.
Collapse
|
6
|
Balancing Deliberate Practice and Reflection: A Randomized Comparison Trial of Instructional Designs for Simulation-Based Training in Cardiopulmonary Resuscitation Skills. Simul Healthc 2020; 14:175-181. [PMID: 31116169 DOI: 10.1097/sih.0000000000000375] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION A key question in simulation-based education is how to maximize learning within time and resource limits, including how best to balance hands-on practice versus reflective debriefing. Several instructional design frameworks suggest setting the balance according to the type of learning objective(s); however, broad professional activities such as team-based cardiopulmonary resuscitation include several interrelated component skills. This study experimentally manipulated hands-on practice versus reflective debriefing for cardiopulmonary resuscitation skills, hypothesizing that the former best supports learning taskwork (eg, compression quality), whereas the latter best supports learning teamwork. METHODS The study was a randomized comparison trial with a pretest and posttest. Twenty-six teams of 5 to 6 first-year residents underwent either "drill" practice of key resuscitation phases, designed to maximize deliberate practice opportunities for individual and team skills, or "scrimmage" practice, designed to maximize full-scenario rehearsals and reflective debriefs. Key taskwork and teamwork behaviors were coded, and compression quality was collected and analyzed from an accelerometer. RESULTS Most performance parameters improved considerably from a pretest to posttest for both taskwork (eg, percent correct compression depth 62%-81%, P = 0.01) and teamwork (eg, role leadership, 47%-70%, P = 0.00). Only 2 parameters improved differently by condition, favoring "drill" training: checking "Do Not Actively Resuscitate" wristband (odds ratio = 14.75, P = 0.03) and use of compression adjuncts (estimated marginal means = 75% versus 67%, P = 0.03). CONCLUSIONS Consistent with the notion that component skills in resuscitation do not clearly and exclusively constitute "taskwork" versus "teamwork," both instructional designs led to similar improvements despite differences in the balance between hands-on practice versus reflection.
Collapse
|
7
|
Lauridsen KG, Watanabe I, Løfgren B, Cheng A, Duval-Arnould J, Hunt EA, Good GL, Niles D, Berg RA, Nishisaki A, Nadkarni VM. Standardising communication to improve in-hospital cardiopulmonary resuscitation. Resuscitation 2019; 147:73-80. [PMID: 31891790 DOI: 10.1016/j.resuscitation.2019.12.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022]
Abstract
AIM Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. METHODS Modified Delphi consensus process to design standardised communication elements. Feasibility was pilot tested in 16 simulated CPR scenarios (8 scenarios with physician team leaders and 8 with chest compressors) randomized (1:1) to standardised [INTERVENTION] vs. closed-loop communication [CONTROL]. Adherence and efficacy (duration of CC pauses for defibrillation, intubation, rhythm check) was assessed by audiovisual recording. Mental demand and frustration were assessed by NASA task load index subscales. RESULTS Consensus elements for standardised communication included: 1) team preparation 15-30 s before CC interruption, 2) pre-interruption countdown synchronized with last 5 CCs, 3) specific action words for defibrillation, intubation, and interrupting/resuming CCs. Median (Q1,Q3) adherence to standardised phrases was 98% (80%,100%). Efficacy analysis showed a median [Q1,Q3] peri-shock pause of 5.1 s. [4.4; 5.8] vs. 7.5 s. [6.3; 8.8] seconds, p < 0.001, intubation pause of 3.8 s. [3.6; 5.0] vs. 6.9 s. [4.8; 10.1] seconds, p = 0.03, rhythm check pause of 4.2 [3.2,5.7] vs. 8.6 [5.0,10.5] seconds, p < 0.001, median frustration index of 10/100 [5,20] vs. 35/100 [25,50], p < 0.001, and median mental demand load of 55/100 [30,70] vs. 65/100 [50,85], p = 0.41 for standardised vs. closed loop communication. CONCLUSION This pilot study demonstrated feasibility of using consensus-based standardised communication that was associated with shorter CC pauses for defibrillation, intubation, and rhythm checks without increasing frustration index or mental demand compared to current best practice, closed loop communication.
Collapse
Affiliation(s)
- Kasper Glerup Lauridsen
- Research Center for Emergency Medicine, Aarhus University Hospital, Denmark; Department of Internal Medicine, Randers Regional Hospital, Denmark; Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, USA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA.
| | - Ichiro Watanabe
- Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, USA
| | - Bo Løfgren
- Research Center for Emergency Medicine, Aarhus University Hospital, Denmark; Department of Internal Medicine, Randers Regional Hospital, Denmark; Department of Cardiology, Aarhus University Hospital, USA
| | - Adam Cheng
- Department of Pediatrics, Cumming School of Medicine, University of Calgary
| | - Jordan Duval-Arnould
- Simulation Center, Johns Hopkins Medicine, Johns Hopkins University Hospital, USA
| | - Elizabeth A Hunt
- Simulation Center, Johns Hopkins Medicine, Johns Hopkins University Hospital, USA; Division of Health Informatics, Johns Hopkins University Hospital, Johns Hopkins Pediatric Hospital, USA; Department of Pediatrics, Johns Hopkins University School of Medicine
| | - Grace L Good
- Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, USA
| | - Dana Niles
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA
| | - Akira Nishisaki
- Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, USA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA
| | - Vinay M Nadkarni
- Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, USA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA
| |
Collapse
|
8
|
Hunt EA, Jeffers J, McNamara L, Newton H, Ford K, Bernier M, Tucker EW, Jones K, O'Brien C, Dodge P, Vanderwagen S, Salamone C, Pegram T, Rosen M, Griffis HM, Duval-Arnould J. Improved Cardiopulmonary Resuscitation Performance With CODE ACES 2: A Resuscitation Quality Bundle. J Am Heart Assoc 2019; 7:e009860. [PMID: 30561251 PMCID: PMC6405605 DOI: 10.1161/jaha.118.009860] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Over 6000 children have an in‐hospital cardiac arrest in the United States annually. Most will not survive to discharge, with significant variability in survival across hospitals suggesting improvement in resuscitation performance can save lives. Methods and Results A prospective observational study of quality of chest compressions (CC) during pediatric in‐hospital cardiac arrest associated with development and implementation of a resuscitation quality bundle. Objectives were to: 1) implement a debriefing program, 2) identify impediments to delivering high quality CC, 3) develop a resuscitation quality bundle, and 4) measure the impact of the resuscitation quality bundle on compliance with American Heart Association (AHA) Pediatric Advanced Life Support CC guidelines over time. Logistic regression was used to assess the relationship between compliance and year of event, adjusting for age and weight. Over 3 years, 317 consecutive cardiac arrests were debriefed, 38% (119/317) had CC data captured via defibrillator‐based accelerometer pads, data capture increasing over time: (2013:13% [12/92] versus 2014:43% [44/102] versus 2015:51% [63/123], P<0.001). There were 2135 1‐minute cardiopulmonary resuscitation (CPR) epoch data available for analysis, (2013:152 versus 2014:922 versus 2015:1061, P<0.001). Performance mitigating themes were identified and evolved into the resuscitation quality bundle entitled CPR Coaching, Objective‐Data Evaluation, Action‐linked‐phrases, Choreography, Ergonomics, Structured debriefing and Simulation (CODE ACES2). The adjusted marginal probability of a CC epoch meeting the criteria for excellent CPR (compliant for rate, depth, and chest compression fraction) in 2015, after CPR Coaching, Objective‐Data Evaluation, Action‐linked‐phrases, Choreography, Ergonomics, Structured debriefing and Simulation was developed and implemented, was 44.3% (35.3–53.3) versus 19.9%(6.9–32.9) in 2013; (odds ratio 3.2 [95% confidence interval:1.3–8.1], P=0.01). Conclusions CODE ACES2 was associated with progressively increased compliance with AHA CPR guidelines during in‐hospital cardiac arrest.
Collapse
Affiliation(s)
- Elizabeth A Hunt
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD.,2 Department of Pediatrics Johns Hopkins Hospital Baltimore MD.,3 Division of Health Sciences Informatics Johns Hopkins Hospital Baltimore MD.,4 Johns Hopkins Medicine Simulation Center Johns Hopkins Hospital Baltimore MD.,11 Department of Pediatrics Division of Critical Care Medicine Johns Hopkins All Children's Hospital Petersburg FL
| | - Justin Jeffers
- 2 Department of Pediatrics Johns Hopkins Hospital Baltimore MD.,5 Division of Pediatric Emergency Medicine Johns Hopkins Hospital Baltimore MD
| | - LeAnn McNamara
- 6 Department of Pharmacy Johns Hopkins Hospital Baltimore MD
| | - Heather Newton
- 7 Department of Occupational Health Johns Hopkins Hospital Baltimore MD
| | - Kenneth Ford
- 7 Department of Occupational Health Johns Hopkins Hospital Baltimore MD
| | - Meghan Bernier
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD
| | - Elizabeth W Tucker
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD
| | - Kareen Jones
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD.,12 Department of Anesthesiology and Critical Care Medicine Stanford University Stanford CA
| | - Caitlin O'Brien
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD
| | - Pamela Dodge
- 8 Department of Nursing Johns Hopkins Hospital Baltimore MD
| | | | - Cheryl Salamone
- 9 Division of Respiratory Services Johns Hopkins Hospital Baltimore MD
| | - Tamara Pegram
- 8 Department of Nursing Johns Hopkins Hospital Baltimore MD
| | - Michael Rosen
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD.,10 Armstrong Institute for Patient Safety and Quality Johns Hopkins Hospital Baltimore MD
| | - Heather M Griffis
- 13 Healthcare Analytics Unit Children's Hospital of Philadelphia Philadelphia PA
| | - Jordan Duval-Arnould
- 1 Department of Anesthesiology and Critical Care Medicine Johns Hopkins Hospital Baltimore MD.,3 Division of Health Sciences Informatics Johns Hopkins Hospital Baltimore MD.,4 Johns Hopkins Medicine Simulation Center Johns Hopkins Hospital Baltimore MD
| |
Collapse
|
9
|
Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
Collapse
|
10
|
Kobras M, Langewand S, Murr C, Neu C, Schmid J. Short lessons in basic life support improve self-assurance in performing cardiopulmonary resuscitation. World J Emerg Med 2016; 7:255-262. [PMID: 27942341 DOI: 10.5847/wjem.j.1920-8642.2016.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There are several reasons why resuscitation measures may lead to inferior results: difficulties in team building, delayed realization of the emergency and interruption of chest compression. This study investigated the outcome of a new form of in-hospital cardiopulmonary resuscitation (CPR) training with special focus on changes in self-assurance of potential helpers when faced with emergency situations. METHODS Following a 12-month period of CPR training, questionnaires were distributed to participants and non-participants. Those non-participants who intended to undergo the training at a later date served as control group. RESULTS The study showed that participants experienced a significant improvement in self-assurance, compared with their remembered self-assurance before the training. Their self-assurance also was significantly greater than that of the control group of non-participants. CONCLUSION Short lessons in CPR have an impact on the self-assurance of medical and non-medical personnel.
Collapse
Affiliation(s)
- Mario Kobras
- Department of Anaesthesiology, Intensive Care and Emergency Medicine, Asklepios Western Clinical Centre, 20 Suurheid, City of Hamburg 22559, Federal Republic of Germany
| | - Sascha Langewand
- Academy of the Rescue Service Cooperation in Schleswig-Holstein, 50 Esmarch Street, City of Heide 25746, Federal Republic of Germany
| | - Christina Murr
- Academy of the Rescue Service Cooperation in Schleswig-Holstein, 50 Esmarch Street, City of Heide 25746, Federal Republic of Germany
| | - Christiane Neu
- Regio Clinical Center GmbH, Sana Group, 71-75 Ramskamp, Elmshorn 25337, County of Pinneberg, Federal Republic of Germany
| | - Jeannette Schmid
- Executive Committee of the Goethe University, Frankfurt a.M., City of Frankfurt 60323, Federal Republic of Germany
| |
Collapse
|
11
|
Greif R, Lockey A, Conaghan P, Lippert A, De Vries W, Monsieurs K. Ausbildung und Implementierung der Reanimation. Notf Rett Med 2015. [DOI: 10.1007/s10049-015-0092-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
12
|
|
13
|
Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG, Ballance JH, Barelli A, Biarent D, Bossaert L, Castrén M, Handley AJ, Lott C, Maconochie I, Nolan JP, Perkins G, Raffay V, Ringsted C, Soar J, Schlieber J, Van de Voorde P, Wyllie J, Zideman D. European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 2015; 95:288-301. [DOI: 10.1016/j.resuscitation.2015.07.032] [Citation(s) in RCA: 272] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|