Abstract 449: Cost Analysis of a Contextualized Cardiopulmonary Resuscitation Training for Orderlies Participating in In-Hospital Cardiac Arrests

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Christian Vincelette ◽  
Catalina Sokoloff ◽  
François-Martin Carrier ◽  
Pierre Desaulniers ◽  
Nathalie Nadon
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cost Analysis ◽  
Life Support ◽  
Heart Association ◽  
Time Lapse ◽  
Performance Outcomes ◽  
Chest Compressions ◽  
High Quality ◽  
Resuscitation Training ◽  
The Cost

Introduction: Basic life support (BLS) training poses challenges for healthcare organizations. It requires numerous resources, complicates scheduling and is expensive. Orderlies typically provide chest compressions during in-hospital cardiac arrests, and are therefore recertified in cardiopulmonary resuscitation (CPR) every 2 years. However, such time lapse between CPR certifications induces skills decay. Hypothesis: Based on the American Heart Association statement on resuscitation education science published in 2018, we aimed to train all orderlies (n= 900) in less than 1 year, in order to reach proficiency in chest compressions, at a fraction of the cost. Method: A shortened (20 minutes), and adapted version of CPR training was created. This training specifically addressed high quality chest compressions, the cornerstone skill relevant to the scope of practice of orderlies in CPR. It was delivered in situ during working hours, as a mass training program that spanned over a period of 1 week. The training was provided through Mastery Learning and Deliberate Practice with direct feedback and live coaching. The cost analysis aimed to compare the costs of the new approach as compared to BLS training. Results: With this innovative approach, 30 trainers were able to train 600 employees in only 5 days. Preliminary results suggest most were able to perform high quality compressions after training. The total cost of the activity was 2 347.21 $CAD which represents 3% (2 347 of 76 200) of what it would take to train 600 people in BLS (76 200$CAD), and 13% (2 347 of 18 000) of the budget planned per year for orderlies’ BLS training at our institution (~18 000$CAD). The individual cost of our initiative was 4.13$CAD per employee. This method allowed to train employees around the clock, to cover all working shifts, thereafter preventing the removal of employees from the rolling schedule. Also, this solution allows us to repeat the experience another time this year, to train all orderlies. Conclusions: Although further research is needed to assess if skills are sustained over time and comparable based on performance outcomes, our inquiry is an innovative, sustainable and cost-effective way to train specific CPR skills to large groups.

Cardiopulmonary resuscitation: the science behind the hands

Heart ◽  
2018 ◽  
Vol 104 (13) ◽  
pp. 1056-1061 ◽  
Author(s):  
Andrew W Harris ◽  
Peter J Kudenchuk
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
Scientific Basis ◽  
Chest Compressions ◽  
High Quality ◽  
Physiological Basis ◽  
Successful Resuscitation ◽  
External Chest Compressions

Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.

Automated Audiovisual Feedback in Cardiopulmonary Resuscitation Training: Improving Skills in Pediatric Intensive Care Nurses

2018 ◽  
Vol 38 (5) ◽  
pp. 59-66
Author(s):  
Robert Bishop ◽  
Brian Joy ◽  
Melissa Moore-Clingenpeel ◽  
Tensing Maa
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Health Care Professionals ◽  
Life Support ◽  
Target Range ◽  
Compression Rate ◽  
Improvement Program ◽  
High Quality ◽  
Median Percentage ◽  
Compression Depth ◽  
Resuscitation Training

Background High-quality cardiopulmonary resuscitation is associated with improved survival and neurological outcomes after cardiac arrest. Unfortunately, health care professionals frequently do not perform resuscitation within guidelines after life-support training. Objectives To determine if brief intermittent training in cardiopulmonary resuscitation could improve nurses’ skills to perform high-quality resuscitation 70% or more of the time during 2 minutes of cardiopulmonary resuscitation after 3 training sessions. Methods In a prospective single-center quality improvement program, pediatric critical care nurses had monthly training in cardiopulmonary resuscitation. A portable manikin/defibrillator with a chest compression sensor was used to provide corrective audiovisual feedback to optimize resuscitation skills. Resuscitation was practiced on an adult manikin. Target goals were compression depth 2 in or greater at a compression rate of 100/min to 120/minute. Percentage of time in the target range and mean compression depth and rate were recorded. Data were collected every other month. The percentage of time both compression rate and depth were in the target range was compared among nurses with different total numbers of training sessions. Results Of the 62 nurses who participated in the training, 48 had data collected. The median percentage of time in the target range improved from 29% with no training to 46% after 1 session, 54% after 2 sessions, 68% after 3 sessions, and 74% after 4 sessions (P = .001). Compression depth increased with the number of training sessions (P = .002). Conclusions This training program in cardiopulmonary resuscitation yielded significant skill improvement and retention.

scholarly journals Can real-time feedback improve the simulated infant cardiopulmonary resuscitation performance of basic life support and lay rescuers?

2019 ◽  
Vol 104 (8) ◽  
pp. 793-801 ◽  
Author(s):  
Jeyapal Kandasamy ◽  
Peter S Theobald ◽  
Ian K Maconochie ◽  
Michael D Jones
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Chest Compression ◽  
Duty Cycle ◽  
Basic Life Support ◽  
Life Support ◽  
Cycle Performance ◽  
Chest Compressions ◽  
High Quality ◽  
Single Measure

BackgroundPerforming high-quality chest compressions during cardiopulmonary resuscitation (CPR) requires achieving of a target depth, release force, rate and duty cycle.ObjectiveThis study evaluates whether ‘real time’ feedback could improve infant CPR performance in basic life support-trained (BLS) and lay rescuers. It also investigates whether delivering rescue breaths hinders performing high-quality chest compressions. Also, this study reports raw data from the two methods used to calculate duty cycle performance.MethodologyBLS (n=28) and lay (n=38) rescuers were randomly allocated to respective ‘feedback’ or ‘no-feedback’ groups, to perform two-thumb chest compressions on an instrumented infant manikin. Chest compression performance was then investigated across three compression algorithms (compression only; five rescue breaths then compression only; five rescue breaths then 15:2 compressions). Two different routes to calculate duty cycle were also investigated, due to conflicting instruction in the literature.ResultsNo-feedback BLS and lay groups demonstrated <3% compliance against each performance target. The feedback rescuers produced 20-fold and 10-fold increases in BLS and lay cohorts, respectively, achieving all targets concurrently in >60% and >25% of all chest compressions, across all three algorithms. Performing rescue breaths did not impede chest compression quality.ConclusionsA feedback system has great potential to improve infant CPR performance, especially in cohorts that have an underlying understanding of the technique. The addition of rescue breaths—a potential distraction—did not negatively influence chest compression quality. Duty cycle performance depended on the calculation method, meaning there is an urgent requirement to agree a single measure.

scholarly journals PENGETAHUAN PERAWAT TENTANG HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) DI ENAM RUMAH SAKIT SWASTA DI INDONESIA [NURSES' KNOWLEDGE ABOUT HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) IN SIX PRIVATE HOSPITALS IN INDONESIA]

2021 ◽  
Vol 9 (2) ◽  
pp. 149
Author(s):  
Anugerah Ruben Ananda ◽  
Desi Friska Dela Zalukhu ◽  
Firdaus G Junior ◽  
Marisa Junianti Manik ◽  
Swingly Wikliv D
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Sampling Technique ◽  
Total Sample ◽  
Health Providers ◽  
High Quality ◽  
Private Hospitals ◽  
Heart Attacks ◽  
Quantitative Descriptive

<p><em>Cardiac arrest is a significant cause of death worldwide, and an estimated 17.9 million people die from heart disease. In 2016, cardiac arrest represented 31% of all global deaths, and heart attacks and strokes caused 85%. In the treatment of cardiac arrest, health providers must perform cardiac and pulmonary resuscitation, a combination of chest compressions, and assistance for the victim's breathing. Nurses must be able to provide high-quality CPR to the patients for optimal outcomes. This study aimed to describe the knowledge of nurses in six private hospitals in Indonesia about high-quality CPR. This research was quantitative descriptive using a modified questionnaire regarding the theory of high-quality CPR. The population in this study were nurses from adult inpatient wards at six private hospitals in Indonesia with a total sample of 86 respondents through convenience sampling technique. The results showed that 79.1% inpatient nurses at six hospitals in Indonesia had good knowledge about high-quality CPR. Nurses are expected to maintain and improve their knowledge and ability to provide high-quality CPR so that the basic life support provided will be of high quality and provide optimal results for cardiac arrest patients in hospitals.</em><strong><br /><br />BAHASA INDONESIA ABSTRAK: </strong>Henti jantung merupakan penyebab kematian yang signifikan di dunia dan diperkirakan 17,9 juta orang meninggal karena penyakit jantung. Pada 2016, henti jantung mewakili 31% dari semua kematian global, dan 85% disebabkan oleh serangan jantung dan stroke. Dalam penanganan henti jantung, perawat harus melakukan resusitasi jantung dan paru yaitu kombinasi dari kompresi dada dan bantuan terhadap pernafasan korban. Tenaga kesehatan harus mampu memberikan<em> high-quality</em> CPR kepada korban untuk hasil yang optimal. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan perawat tentang high-quality CPR di enam rumah sakit swasta di Indonesia. Penelitian ini merupakan studi deskriptif kuantitatif dengan menggunakan kuesioner mengenai teori <em>high-quality</em> CPR yang telah dimodifikasi. Populasi dalam penelitian ini adalah perawat ruang rawat inap dewasa di enam rumah sakit swasta di Indonesia dengan jumlah sampel sebanyak 86 responden melalui teknik sampel konvenien. Hasil penelitian menunjukan 79.1% perawat rawat inap di enam rumah sakit di Indonesia memiliki pengetahuan tentang <em>high-quality</em> CPR pada tingkat yang baik. Perawat diharapkan untuk tetap mempertahankan dan meningkatkan pengetahuan dan kemampuan pemberian <em>high-quality CPR</em> sehingga bantuan hidup dasar yang diberikan akan berkualitas dan memberikan hasil optimal bagi pasien henti jantung dalam rumah sakit.</p>

scholarly journals USING CHEST COMPRESSIONS WITH ASYNCHRONOUS VENTILATION AT VARIOUS CHEST COMPRESSION RATES (90, 100, 120/MIN) – A RANDOMIZED CONTROLLED ANIMAL TRIAL

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e28
Author(s):  
Sparsh Patel ◽  
Po-Yin Cheung ◽  
Tze-Fun Lee ◽  
Matteo Pasquin ◽  
Megan O’Reilly ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Porcine Model ◽  
Life Support ◽  
Neonatal Resuscitation ◽  
Chest Compressions ◽  
Neonatal Asphyxia ◽  
Significant Difference ◽  
Post Test ◽  
The Mean

Abstract BACKGROUND The current Pediatric Advanced Life Support guidelines recommends that newborns who require cardiopulmonary resuscitation (CPR) in settings (e.g., prehospital, Emergency department, or paediatric intensive care unit, etc.) should receive continuous chest compressions with asynchronous ventilations (CCaV) if an advanced airway is in place. However, this has never been examined in a newborn model of neonatal asphyxia. OBJECTIVES To determine if CCaV at rates of 90/min or 120/min compared to current standard of 100/min will reduce the time to return of spontaneous circulation (ROSC) in a porcine model of neonatal resuscitation. DESIGN/METHODS Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 40-min normocapnic hypoxia followed by asphyxia, which was achieved by clamping the endotracheal tube until asystole. Piglets were randomized into 3 CCaV groups: chest compression (CC) at a rate of 90/min (CCaV 90,n=7), of 100/min (CCaV 100,n=7), of 120/min (CCaV 120,n=7), or sham-operated group. A two-step randomization process with sequentially numbered, sealed brown envelope was used to reduce selection bias. After surgical instrumentation and stabilization an envelope containing the allocation “sham” or “intervention” was opened (step one). The sham-operated group had the same surgical protocol, stabilization, and equivalent experimental periods without hypoxia and asphyxia. Only piglets randomized to “intervention” underwent hypoxia and asphyxia. Once the criteria for CPR were met, a second envelope containing the group allocations was opened (step two). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. RESULTS The mean (±SD) duration of asphyxia was similar between the groups with 260 (±133)sec, 336 (±217)sec, and 231 (±174)sec for CCav 90, CCaV 100, and CCaV 120, respectively (p=1.000; oneway ANOVA with Bonferroni post-test). The mean (SD) time to ROSC was also similar between groups 342 (±345)sec, 312 (±316)sec, and 309 (±287)sec for CCav 90, CCaV 100, and CCaV 120, respectively (p=1.000; oneway ANOVA with Bonferroni post-test). Overall, 5/7 in the CCaV 90, 5/7 in CCaV 100, and 5/7 in the CCaV 120 survived. CONCLUSION There was no significant difference in time to ROSC for either chest compression technique during cardiopulmonary resuscitation in a porcine model of neonatal asphyxia.

The Potential Impact of Cardiopulmonary Cerebral Resuscitation (CPCR) Education

1985 ◽  
Vol 1 (S1) ◽  
pp. 70-74
Author(s):  
Peter Safar
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Heart Association ◽  
Pilot Project ◽  
World Federation ◽  
Ambulance Personnel ◽  
Knowledge And Skills ◽  
Training Systems ◽  
Resuscitation Training ◽  
Potential Impact

This is an introduction for a one-day CPCR course for intended instructors-coordinators. The course is a pilot project using a new manual. Its goal is to explore the feasibility of instructors using semi-self-training modes to acquire the necessary knowledge and skills for the organization of basic and advanced life support courses in CPR for all types of personnel, ranging from the lay public via ambulance personnel and nurses to physician generalists and physician specialists. The American Heart Association (AHA) CPR courses for instructors-to-be were originated in Pittsburgh in the early 1960s; this present course, sponsored by the World Federation of Societies of Anesthesiologists (WFSA) CPR Committee was given in 1981. The traditional 2 to 3 days CPR instructors' courses for physicians have spread knowledge and skills slowly. We believe that the dissemination and uniformity of resuscitation training could be enhanced by wider use of self-training systems, not only for doers but also instructors-to-be.

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