Abstract 229: Cardiopulmonary Resuscitation Compliance of Clinical Nurses Using Feedback Technology from the Zoll R Series Defibrillator

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Martha A Boudreau
Keyword(s):  
Visual Feedback ◽  
Chest Compression ◽  
Technology Use ◽  
Healthcare Providers ◽  
Rest Period ◽  
Visual Display ◽  
Chest Compressions ◽  
Compression Performance ◽  
Clinical Nurses ◽  
Use Of Technology

Use of technology driven devices aimed at providing audio-visual feedback during CPR have been developed, however research is limited to their usefulness effecting chest compression quality of clinical nurses who are often first to respond and begin chest compression on patients experiencing cardiac arrest. This study aimed to examine CPR chest compression compliance of nurses with and without feedback from the Zoll R Series® defibrillator on a manikin. Hypothesis: Audio-visual feedback technology use from the Zoll R Series defibrillator improves the percentage of appropriate chest compression depth and rate of nurses during a CPR manikin demonstration exercise. Methods: Thirty-four nurses participated using an AHA approved manikin. Each nurse performed two minutes of uninterrupted chest compressions without feedback, followed by a rest period and two minutes of uninterrupted chest compressions using feedback technology from the defibrillator. Compression data for rate and depth and total compressions in target within AHA 2015 ECC Guidelines were recorded by the defibrillator and entered into Zoll RescueNet® software. Demographics obtained for years of BLS and ACLS certification. Results: Of the 34 nurses, mean years of ACLS certification was 3.4 years and 11.7 certified years of BLS. Compressions performed with feedback showed a higher percentage of compressions in target (M = 87.37, SD= 15.95) including rate (M= 86.33, SD =15.13) and depth (M= 97.12, SD = 5.63) of compressions compared to percent compressions in target without feedback (M= 64.42, SD = 30.54) including rate (M= 65.73, SD = 32.44) and depth (M=93.34, SD = 19.99) of compressions. Twenty nine or 85% of the 34 nurses improved chest compression performance using feedback. No significant correlation found between years of BLS and ACLS certification and pre and post feedback compliance. Conclusions: Defibrillators offering verbal encouragement and a visual display allow for adjustments in rate and depth of compressions to maintain chest compressions compliance within ECC Guidelines. Further studies should investigate whether the incorporation of feedback technology use in mock code and CPR training sessions could improve CPR performance of healthcare providers including nurses.

Why Do People Resist Patient Portal Systems?

2019 ◽  
pp. 407-428 ◽  
Author(s):  
Bahae Samhan
Keyword(s):  
Technology Use ◽  
Structural Equation ◽  
Factor Model ◽  
Resistance To Change ◽  
Healthcare Providers ◽  
Equation Modeling ◽  
Universal Theory ◽  
Patient Portal ◽  
Healthcare Settings ◽  
Use Of Technology

The implementation of patient portal systems (PPS) has potential benefits to both healthcare providers and their patients. However, evidence shows that PPS are being resisted by patients. Little research in IS has addressed this phenomenon. To understand PPS resistance, this study uses the dual factor model of IT usage to develop an integration of the user resistance model (URM) with the universal theory of acceptance and use of technology (UTAUT). Survey data were used to test the integrative model. A total of 265 responses were gathered from patients at a large international hospital. The data were analyzed using structural equation modeling (EQM). The results revealed resistance to change as an inhibitor to intentions to use the PPS. This study demonstrated the importance of integrating resistance to change with the technology use research, especially in healthcare settings. Moreover, this study is considered to be among the few studies in IS to incorporate patients' perspectives regarding new healthcare technology.

scholarly journals Bystander fatigue and CPR quality by older bystanders: a randomized crossover trial comparing continuous chest compressions and 30:2 compressions to ventilations

CJEM ◽  
2016 ◽  
Vol 18 (6) ◽  
pp. 461-468 ◽  
Author(s):  
Shawn Liu ◽  
Christian Vaillancourt ◽  
Ann Kasaboski ◽  
Monica Taljaard
Keyword(s):  
Chest Compression ◽  
Crossover Trial ◽  
Tertiary Care ◽  
Rest Period ◽  
Mean Difference ◽  
Chest Compressions ◽  
Lay Persons ◽  
Randomized Crossover Trial ◽  
Cpr Quality ◽  
Cpr Training

ABSTRACTObjectivesThis study sought to measure bystander fatigue and cardiopulmonary resuscitation (CPR) quality after five minutes of CPR using the continuous chest compression (CCC) versus the 30:2 chest compression to ventilation method in older lay persons, a population most likely to perform CPR on cardiac arrest victims.MethodsThis randomized crossover trial took place at three tertiary care hospitals and a seniors’ center. Participants were aged ≥55 years without significant physical limitations (frailty score ≤3/7). They completed two 5-minute CPR sessions (using 30:2 and CCC) on manikins; sessions were separated by a rest period. We used concealed block randomization to determine CPR method order. Metronome feedback maintained a compression rate of 100/minute. We measured heart rate (HR), mean arterial pressure (MAP), and Borg Exertion Scale. CPR quality measures included total number of compressions and number of adequate compressions (depth ≥5 cm).ResultsSixty-three participants were enrolled: mean age 70.8 years, female 66.7%, past CPR training 60.3%. Bystander fatigue was similar between CPR methods: mean difference in HR -0.59 (95% CI −3.51-2.33), MAP 1.64 (95% CI −0.23-3.50), and Borg 0.46 (95% CI 0.07-0.84). Compared to 30:2, participants using CCC performed more chest compressions (480.0 v. 376.3, mean difference 107.7; p<0.0001) and more adequate chest compressions (381.5 v. 324.9, mean difference. 62.0; p=0.0001), although good compressions/minute declined significantly faster with the CCC method (p=0.0002).ConclusionsCPR quality decreased significantly faster when performing CCC compared to 30:2. However, performing CCC produced more adequate compressions overall with a similar level of fatigue compared to the 30:2 method.

scholarly journals Chest compression effectiveness with vs without feedback

2019 ◽  
Vol 2 (2) ◽  
pp. 83-84
Author(s):  
BinGe Yang ◽  
Matthew Douma ◽  
Christopher Picard
Keyword(s):  
Chest Compression ◽  
Null Hypothesis ◽  
Rest Period ◽  
T Test ◽  
Chest Compressions ◽  
Convenience Sample ◽  
Cpr Quality ◽  
Data Tracking ◽  
Giving Feedback ◽  
The Impact

The objective of this experiment is to assess clinician perceived versus actual compression quality, and to evaluate the impact of using feedback from the Laerdal CPRMeter2 on compression quality.  In our setup, we have a total of eighty four participants (43 from the Royal Alex and 41 from the Misericordia hospital). We monitored CPR quality based on the guidelines by Heart and Stroke, which breaks down chest compression effectiveness into three areas- Release, Depth and Rate. Proper Guidelines: Compress the chest at least 5cm (2inches); Compress at a rate of 100 to 120 beats per minute; Allow the chest to recoil completely after each compression. Clinical Setup: A convenience sample of participants performed two minutes of uninterrupted chest compressions on a Laerdal Resusci Anne with a CPRmeter2 on top without feedback, followed by a two minute rest period to fill out a Q.I tracking form. They later repeated the two minutes of chest compressions with the display of the CPRmeter uncovered, with the feedback visible. The chest compression metrics from the trials were compared using a data tracking form. From the data collected, enough evidence shows that the CPRmeter2 is able to improve release, rate and overall CPR quality. After filling out the survey, all of the nurses agree that the device is very useful in giving feedback and should be used in future CPR classes. Furthermore, data collected from the Q.I tracking forms indicates that nurses and other health clinicians are inadequate in predicting their own CPR abilities. Often times, nurses would either overpredict or underpredict their scores on the CPR meter. From the data gathered, the CPRmeter2 is going to be used for training in future CPR classes. Just recently, the device has been incorporated into code calls in the emergency department at the Misericordia. A T-test was done on the findings from the experiment to test if the means of two sets of data are significantly different from each other. Based on our findings, the t-test values for rate, release, and overall quality are statistically significant, meaning that the null hypothesis is rejected.  

Why Do People Resist Patient Portal Systems?

2017 ◽  
Vol 12 (4) ◽  
pp. 68-86 ◽  
Author(s):  
Bahae Samhan
Keyword(s):  
Technology Use ◽  
Structural Equation ◽  
Factor Model ◽  
Resistance To Change ◽  
Healthcare Providers ◽  
Integrative Model ◽  
Equation Modeling ◽  
Universal Theory ◽  
Patient Portal ◽  
Use Of Technology

The implementation of patient portal systems (PPS) has potential benefits to both healthcare providers and their patients. However, evidence shows that PPS are being resisted by patients. Little research in IS has addressed this phenomenon. To understand PPS resistance, this study uses the dual factor model of IT usage to develop an integration of the user resistance model (URM) with the universal theory of acceptance and use of technology (UTAUT). Survey data were used to test the integrative model. A total of 265 responses were gathered from patients at a large international hospital. The data were analyzed using structural equation modeling (EQM). The results revealed resistance to change as an inhibitor to intentions to use the PPS. This study demonstrated the importance of integrating resistance to change with the technology use research, especially in healthcare settings. Moreover, this study is considered to be among the few studies in IS to incorporate patients' perspectives regarding new healthcare technology.

Abstract P149: CPR Feedback Improves the Quality of Chest Compressions Performed by Healthcare Providers

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Mary Ann Peberdy ◽  
Annemarie Silver ◽  
Phyllis Faulkenberry ◽  
Lisa Ferland ◽  
Joseph Ornato
Keyword(s):  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Rest Period ◽  
Chest Compressions

Purpose : Healthcare providers are often unable to perform chest compressions (CC) consistently within AHA guideline recommendations of 100 CC/minute at a depth of 1.5–2 in. The present study examined the effect of audiovisual CPR feedback on the quality of CC performed by healthcare providers. Methods: One hundred twenty-five ACLS and BCLS trained hospital based healthcare professionals participated in “CPR challenges” at 14 U.S. hospitals. Participants performed 2 minutes of CC on a manikin without any feedback initially. Following a ≥90 second rest period and ~20 second orientation to the audiovisual feedback prompts, participants repeated 2 minutes of CC with feedback prompts. Data were recorded using a ZOLL AED Plus. Rescuers were categorized based upon mean depth of CC without feedback: 1) under-performers (depth<1.5in; n=60); 2) within guideline-performers (depth<1.5–2in; n=52); and 3) over-performers (depth>2in; n=13). Results: Mean depth of CC improved with CPR feedback (1.57±0.36in without feedback vs. 1.71±0.13in with feedback, mean±SD, p<0.0001) and the percentage of CC within 1.5–2in increased from 38 to 87% (p<0.0001). In under-performers, depth of CC substantially increased with CPR feedback (1.30±0.12 vs. 1.66±0.13in; p<0.0001) and the percentage of CC within 1.5–2in improved from 9 to 81% (p<0.0001). Over-performers were corrected to meet AHA guidelines for depth with feedback (2.31±0.40 vs. 1.83±0.07in, p=0.001). The percentage of CC within 1.5–2 in improved from 13 to 90% with feedback (p<0.0001). For within guideline-performers, depth of CC was similar with and without feedback (1.70±0.14 vs.1.74±0.10in, p=0.08) but the percentage of CC within 1.5–2 in increased with feedback from 79 to 92% (p<0.0001). Rate of CC was corrected with CPR feedback in under-performers (110±17 vs. 100±4 CC/min, p<0.0001) but was unchanged with feedback in within guideline-performers (103±15 vs. 100±3 CC/min, p=0.2) and over-performers (97±14 vs. 100±8 CC/min, p=0.4). Conclusions: Audiovisual feedback improves the quality of CC provided by hospital-based healthcare professionals in a manikin testing scenario. Healthcare providers can improve consistency of CC with CPR feedback regardless of their performance without feedback.

Abstract 17534: The Most Appropriate Number of Personnel Needed for Chest Compressions for In-hospital Cardiac Arrest: A Randomized, Crossover Manikin Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shunsuke Yamanaka ◽  
Kei Nishiyama ◽  
Hiroyuki Hayashi ◽  
Ji Young Huh
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Healthcare Providers ◽  
Preliminary Evaluation ◽  
Chest Compressions ◽  
Rescue Team ◽  
Manikin Study ◽  
Hospital Cardiac Arrest

Background: Effective chest compression (CC) is vital in cardiopulmonary resuscitation (CPR), and rescuer’s fatigue negatively affects quality of CPR. However, there is no consensus on the appropriate number of personnel needed for CC to avoid rescuer’s fatigue. Objective: We determined the appropriate number of personnel needed for 30-min CPR in a rescue-team in a hospital. Methods: We conducted a preliminary randomized, crossover, manikin trial on healthcare providers. We divided them into Groups A to D according to the intervals between the 2-min CC and assigned a different interval to each group. Groups A, B, C, and D performed CCs at 2-, 4-, 6-, and 8-min intervals as in 2, 3, 4, and 5 personnel, respectively. All participants performed CCs for 30 min with different intervals depending on the assigned group; participants allocated to Groups A, B, C, and D performed 8, 5, 4, and 3 cycles, respectively. We compared the differences between first cycle and the second to the last cycle Results: We enrolled 42 participants (age: 25.2±4.2, men 47.6%) for the preliminary evaluation. We used Kruskal-Wallis for the analysis. Participants in the less interval Groups A and B performed faster (A: -24.28±15.18, B: -7.90±13.49, C: -11.27±17.01, D: -2.38±3.31, P=0.03) and shallower CCs (A: -4.42±6.92, B: -3.18±5.43, C: -0.18±5.74, D: -1.23±4.10, P=0.62). Women-rescuers performed faster (A: -27.25±12.23, B: -7.00±13.97, C: -8.16±19.26, D: 3.16±4.66, P= 0.05) and shallower CCs (A: -6.25±7.54, B: -3.00±6.89, C: -3.66±3.32, D: -0.16±4.35, P=0.58). However, CCs of men-rescuers were not faster (A: -20.33±20.65, B: -9.00±14.44, C: -15.00±15.11, D: -7.14±16.70, P= 0.60) or shallower (A: -2.00±6.55 B: -3.40±3.78, C: 4.00±5.33, D: -2.14±3.98, P=0.06). Conclusion: At least four rescuers (Group C) may be needed to reduce rescuer’s fatigue for 30-min CPR. If the team only includes women, more personnel would be needed as women experience fatigue faster.

Abstract 12921: One Hand Open Palm Technique for Infant Cardiopulmonary Resuscitation: A Randomized Crossover Study

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Shruti Patel ◽  
Shilpa Balikai ◽  
Timothy G Elgin ◽  
Elizabeth A Newell ◽  
Tarah T Colaizy ◽  
...  
Keyword(s):  
Chest Compression ◽  
Nurse Practitioners ◽  
Healthcare Providers ◽  
Rest Period ◽  
Heart Association ◽  
Spontaneous Circulation ◽  
Difficulty Level ◽  
Care Providers ◽  
Compression Depth ◽  
Pediatric Resuscitation

Introduction: The American Heart Association (AHA) CPR guidelines states that effective chest compression depth, rate and recoil are essential factors for establishment of return of spontaneous circulation. A recent survey from an international pediatric resuscitation collaborative showed that healthcare providers failed to meet the metrics of the AHA guidelines, with the greatest difficulty in achieving targeted chest compression depth in infants. The recommended techniques for infant compression include two finger (TFT) or two-thumb technique (TTT). We hypothesized using the heel of one palm (open palm technique, OPT) in infants will result in improved chest compression depth with decreased provider fatigue. Methods: Each participant performed three techniques including TFT, TTT, and novel open-palm technique (OPT) with randomization for sequence of techniques for each participant. Each technique was performed for 2 minutes followed by a 5-minute rest period on an infant manikin. Data were collected through Zoll R series defibrillators on chest compression depth, rate, and fraction. At the end of the study, each participant filled out a survey for difficulty level, finger fatigue, and rescuer fatigue. Results: Thirty pediatric critical care providers participated in the study consisting of 16 nurses, 9 respiratory therapists, 3 fellows, 2 nurse practitioners. The mean chest compression depth for OPT was significantly deeper (2.61 ± 0.63 cm) in comparison to TFT (2.25 ± 0.54 cm, p= 0.0004) but not significantly deeper in comparison to TTT (2.43 ± 0.46 cm, p= 0.0820). There were no significant differences between the three techniques in chest compression rate or chest compression fraction. The finger fatigue and rescuer fatigue surveys were graded from 0-10 with 10 being the most fatigue. OPT showed significantly less finger and rescuer fatigue in comparison to TTT and TFT (p<0.05). Conclusion: This study demonstrated that OPT generated improved chest compression depth with considerably less rescuer and finger fatigue. However, chest compression depth with all three techniques failed to meet the AHA infant goal of 4 cm. Further research is needed to optimize CPR performance to achieve the targeted chest compression depth in infants.

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