Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes
Objective: We sought to identify changes in neurological outcome over time following initial training and subsequent implementation of team-focused CPR in an inpatient setting where responders practice specific roles with emphasis on minimally interrupted chest compressions and early defibrillation....
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-06-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424000717 |
| _version_ | 1797221689644285952 |
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| author | David A. Pearson Nicole Bensen Covell Benjamin Covell Blake Johnson Cate Lounsbury Mike Przybysz Anthony Weekes Michael Runyon |
| author_facet | David A. Pearson Nicole Bensen Covell Benjamin Covell Blake Johnson Cate Lounsbury Mike Przybysz Anthony Weekes Michael Runyon |
| author_sort | David A. Pearson |
| collection | DOAJ |
| description | Objective: We sought to identify changes in neurological outcome over time following initial training and subsequent implementation of team-focused CPR in an inpatient setting where responders practice specific roles with emphasis on minimally interrupted chest compressions and early defibrillation. Methods: This retrospective pre- vs post-intervention study was conducted at an urban 900-bed teaching hospital and Level I Cardiac Resuscitation Center. We included adult patients suffering in-hospital cardiac arrest occurring in non-emergency department and non-intensive care unit areas who received CPR and/or defibrillation. We compared survival with good neurological outcome at time of hospital discharge in the one-year periods before and after implementation of team-focused CPR. To investigate skill degradation, we compared cumulative survival with good neurological outcome in 3-month intervals against the before team-focused CPR baseline. Trained research associates abstracted explicitly defined variables from electronic health records using a standardized form and data dictionary to achieve consistency between collaborators. Results: Of 296 IHCAs, 207 patients met inclusion criteria and were analyzed. In 104 patients before team-focused CPR initiation, survival with good neurological outcome was 21%. In the 12-month period following team-focused CPR initiation, survival with good neurological outcome was 31% in 101 patients, risk difference 9.9% (95% CI −2 to 22%; p = 0.14). By quarterly time intervals, following team-focused CPR implementation, the cumulative survival with good neurological outcome at 3 months was 42%; at 6 months 37%; at 9 months 31%; and at 12 months 31%. Conclusion: In our single-institution implementation of team-focused CPR for in-hospital cardiac arrest, outcomes significantly improved at 6 months before declining towards baseline. |
| first_indexed | 2024-04-24T13:09:26Z |
| format | Article |
| id | doaj.art-46abe8af36324742a11efa58ef68ccaf |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-24T13:09:26Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-46abe8af36324742a11efa58ef68ccaf2024-04-05T04:41:43ZengElsevierResuscitation Plus2666-52042024-06-0118100620Effectiveness of team-focused CPR on in-hospital CPR quality and outcomesDavid A. Pearson0Nicole Bensen Covell1Benjamin Covell2Blake Johnson3Cate Lounsbury4Mike Przybysz5Anthony Weekes6Michael Runyon7Dept. of Emergency Medicine, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203, United States; Corresponding author at: Department of Emergency Medicine, Medical Education Building, 3rd Floor, 1000 Blythe Blvd, Charlotte, NC 28203, United States.Campbell University School of Osteopathic Medicine, 4350 US Hwy 421 S, Lillington, NC 27546, United StatesUNC Johnston Health, Wake Emergency Physicians, P.A., 3000 New Bern Ave, Raleigh, NC 27610, United StatesDept. of Emergency Medicine, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246, United StatesDept. of Emergency Medicine, Spartanburg Regional Medical Center, 101 E Wood St, Spartanburg, SC 29303, United StatesPulmonary Critical Care Consultants, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203, United StatesDept. of Emergency Medicine, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203, United StatesDept. of Emergency Medicine, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203, United StatesObjective: We sought to identify changes in neurological outcome over time following initial training and subsequent implementation of team-focused CPR in an inpatient setting where responders practice specific roles with emphasis on minimally interrupted chest compressions and early defibrillation. Methods: This retrospective pre- vs post-intervention study was conducted at an urban 900-bed teaching hospital and Level I Cardiac Resuscitation Center. We included adult patients suffering in-hospital cardiac arrest occurring in non-emergency department and non-intensive care unit areas who received CPR and/or defibrillation. We compared survival with good neurological outcome at time of hospital discharge in the one-year periods before and after implementation of team-focused CPR. To investigate skill degradation, we compared cumulative survival with good neurological outcome in 3-month intervals against the before team-focused CPR baseline. Trained research associates abstracted explicitly defined variables from electronic health records using a standardized form and data dictionary to achieve consistency between collaborators. Results: Of 296 IHCAs, 207 patients met inclusion criteria and were analyzed. In 104 patients before team-focused CPR initiation, survival with good neurological outcome was 21%. In the 12-month period following team-focused CPR initiation, survival with good neurological outcome was 31% in 101 patients, risk difference 9.9% (95% CI −2 to 22%; p = 0.14). By quarterly time intervals, following team-focused CPR implementation, the cumulative survival with good neurological outcome at 3 months was 42%; at 6 months 37%; at 9 months 31%; and at 12 months 31%. Conclusion: In our single-institution implementation of team-focused CPR for in-hospital cardiac arrest, outcomes significantly improved at 6 months before declining towards baseline.http://www.sciencedirect.com/science/article/pii/S2666520424000717CPRCardiac arrestTeam learningEducation |
| spellingShingle | David A. Pearson Nicole Bensen Covell Benjamin Covell Blake Johnson Cate Lounsbury Mike Przybysz Anthony Weekes Michael Runyon Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes Resuscitation Plus CPR Cardiac arrest Team learning Education |
| title | Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes |
| title_full | Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes |
| title_fullStr | Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes |
| title_full_unstemmed | Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes |
| title_short | Effectiveness of team-focused CPR on in-hospital CPR quality and outcomes |
| title_sort | effectiveness of team focused cpr on in hospital cpr quality and outcomes |
| topic | CPR Cardiac arrest Team learning Education |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424000717 |
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