Resuscitation quality improvement program to improve the acquisition and retention of cardiopulmonary resuscitation skills for healthcare professionals in emergency department

doi:10.3760/cma.j.cn115259-20230822-00153

Abstract

Abstract: Objective This study aims to evaluate the effectiveness of the resuscitation quality improvement (RQI) program in cardiopulmonary resuscitation (CPR) training for emergency department personnel. Methods From April 2021 to April 2022, a cohort of 149 healthcare professionals from the Emergency Department of Peking Union Medical College Hospital were enrolled in CPR training using the RQI program. Test scores of pre-training, post-training and four quarterly refresher training periods (Q1, Q2, Q3, Q4) were collected, questionnaires were also used to assess the training effects. Non-parametric Wilcoxon rank-sum tests were used for data analysis. Results There were statistical improvements in CPR test scores from pre- to post-training for adult compressions [64.5 (59.0) vs. 96.0 (15.0)], adult ventilation [42.5 (86.0) vs. 97.5 (14.0)], infant compressions [24.0 (73.0) vs. 94.0 (19.0)], and infant ventilation [28.5 (57.0) vs. 74.5 (46.0)](all P < 0.05). The adult compression scores for Q1, Q2, Q3, and Q4 were 97.0 (3.0), 98.0 (4.0), 97.0 (5.0), and 98.0 (4.0), respectively, and the infant compression scores were 98.0 (6.0), 98.0 (5.0), 99.0 (8.0), and 98.0 (5.0), respectively. The adult ventilation scores were 99.0 (3.0), 99.0 (3.0), 99.0 (7.0), and 99.0 (3.0), and the infant ventilation scores were 98.0 (7.0), 98.0 (8.0), 99.0 (5.0), and 99.0 (5.0), all with no statistical differences across the four quarters (all P>0.05). The participation rate was 99.3%(148/149) for Q1, 96.6%(144/149) for Q2, 94.6%(141/149) for Q3, and 91.9%(137/149) for Q4. The overall satisfaction rate was 89.1%(122/137). Conclusions The RQI program for CPR training in the emergency department was effective in enabling participants to acquire and maintain core skills, with high levels of course compliance and satisfaction. RQI could be an alternative approach for CPR training among emergency clinicians and nurses.

Key words: Cardiopulmonary resuscitation, Emergency department, Basic life support, Resuscitation quality improvement

CLC Number:

Jiang Hui, Song Xiao, Zong Liang, Zhu Huadong, Liu Jihai, Shi Di. Resuscitation quality improvement program to improve the acquisition and retention of cardiopulmonary resuscitation skills for healthcare professionals in emergency department[J]. Chinese Journal of Medical Education, 2024, 44(12): 943-947.

References

[1] Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association[J]. Circulation, 2013,128(4):417-435. DOI: 10.1161/CIR.0b013e31829d8654.
[2] Nagafuchi K, Hifumi T, Nishimoto N, et al. Chest compression depth and rate effect on instructor visual assessment of chest compression quality[J]. Circ J, 2019,83(2):418-423. DOI: 10.1253/circj.CJ-18-0952.
[3] Jones A, Lin Y, Nettel-Aguirre A, et al. Visual assessment of CPR quality during pediatric cardiac arrest: does point of view matter?[J]. Resuscitation, 2015,90(5):50-55. DOI: 10.1016/j.resuscitation.2015.01.036.
[4] Halm M, Crespo C. Acquisition and retention of resuscitation knowledge and skills: what's practice have to do with it?[J]. Am J Crit Care, 2018,27(6):513-517. DOI: 10.4037/ajcc2018259.
[5] Sutton RM, Niles D, Meaney PA, et al. Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers[J]. Pediatrics,2011,128(1):e145-151. DOI: 10.1542/peds.2010-2105.
[6] Yeung J, Meeks R, Edelson D, et al. The use of CPR feedback/prompt devices during training and CPR performance: a systematic review[J]. Resuscitation,2009,80(7):743-751. DOI: 10.1016/j.resuscitation.2009.04.012.
[7] Oermann MH, Kardong-Edgren S, Odom-Maryon T, et al. Deliberate practice of motor skills in nursing education: CPR as exemplar[J]. Nurs Educ Perspect, 2011,32(5):311-315. DOI: 10.5480/1536-5026-32.5.311.
[8] Dudzik LR, Heard DG, Griffin RE, et al. Implementation of a low-dose high-frequency cardiac resuscitation quality improvement program in a community hospital[J]. Jt Comm J Qual Patient Saf, 2019,45(12):789-797. DOI: 10.1016/j.jcjq.2019.08.010.
[9] Panchal AR, Norton G, Gibbons E, et al. Low dose- high frequency, case based psychomotor CPR training improves compression fraction for patients with in-hospital cardiac arrest[J]. Resuscitation, 2020,146(1):26-31. DOI: 10.1016/j.resuscitation.2019.10.034.
[10] Li T, Essex K, Ebert D, et al. Resuscitation Quality Improvement^®(RQI^®) HeartCode Complete^®program improves chest compression rate in real world out-of hospital cardiac arrest patients[J]. Resuscitation, 2023,188(5):109833. DOI: 10.1016/j.resuscitation.2023.109833.
[11] Kuyt K, Mullen M, Fullwood C, et al. The assessment of a manikin-based low-dose, high-frequency cardiac resuscitation quality improvement program in early UK adopter hospitals[J]. Adv Simul (Lond), 2021,6(1):14. DOI: 10.1186/s41077-021-00168-y.
[12] Jiang H, Zong L, Li F, et al. Initial implementation of the resuscitation quality improvement program in emergency department of a teaching hospital in China[J]. PeerJ, 2022,10(11):e14345-14363. DOI: 10.7717/peerj.14345.
[13] 余薇, 刘晋, 张雯, 等. 基于实时视听反馈的教学方式在心肺复苏实践教学中的应用[J].中华医学教育杂志,2022,42(7):643-647. DOI: 10.3760/cma.j.cn115259-20211227-01585.

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