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

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.

Keywords: CPR; Education; IHCA; Quarterly; Team Training.

Fig. 1

Timeline of Quality Improvement Initiative, Legend- DCCT = Designated Chest Compressor Team, CPR = Cardiopulmonary Resuscitation, IHCA = In-Hospital Cardiac Arrest, Q1 = Quarter 1 training Q2 = Quarter 2 Training, Q3 = Quarter 3 Training, Q4 = Quarter 4 Training.