Hospital Study Demonstrates Remarkable Improvement in CPR Quality with Low-Dose, High-Frequency Training
By: The American Heart Association
University of Alabama at Birmingham (UAB) Hospital emergency department (ED) nurse Tamicka Jones didn’t expect to begin her spring 2016 vacation by saving a life. Jones flew into action the moment she witnessed a man in cardiac arrest in an Atlanta airport terminal, taking charge and putting her medical skills to work. She performed what she characterizes as the most intense cardiopulmonary resuscitation (CPR) of her career, keeping the man’s blood flowing until emergency medical services could arrive and take over. The man survived cardiac arrest in part because Jones remained calm and acted expertly in the eye of the storm.
CPR proficiency was the subject of a recent UAB Hospital ED study in which Jones took part. Hospital staff are traditionally required to undergo formal CPR training once every two years. But is that enough?
CPR is not a part of many health care providers’ regular practices; in fact, some rarely perform CPR other than during their biannual training. The result is less-than-stellar CPR compression and ventilation skills and reduced overall CPR effectiveness — with both potentially affecting patient outcomes.
“High-quality CPR is essential for survival from cardiac arrest,” said lead study author Michael C. Kurz, MD, MS, associate professor in the Department of Emergency Medicine at UAB. “However, the opportunity to perform CPR is too infrequent currently to maintain proficiency for most providers.”
“ED staff at hospitals across the country are required to undergo CPR recertification every two years, but studies have shown that their skills begin to degrade the moment the training session ends, and most people have lost effective skills within 90 days,” said Kurz.
Study Reveals Less Isn’t Always More
For the study, UAB placed two mobile simulation stations with feedback devices in its ED and began quarterly CPR training with 150 nurses in June 2015. One year later, comparison to baseline data revealed that quarterly use of the mobile simulation stations with feedback in real time helped improve chest compression fraction and the percentage of compressions with adequate depth and recoil.
“Clinical data collected before and after implementation of the simulation stations demonstrated a 14 percent improvement in chest compression fraction delivered to cardiac arrest victims in the ED,” said Kurz.
The mobile simulation stations helping to improve UAB’s CPR quality are part of the American Heart Association’s Resuscitation Quality Improvement® (RQI) — an innovative program built on the premise that low-dose, high-frequency training leads to higher-quality CPR skills.
According to Jones, training on the RQI station sharpened her skills and gave her confidence that she was performing CPR at a high level of effectiveness.
One of the program’s key benefits is the tremendous culture change that has occurred as a result of having the RQI simulation stations embedded in the ED, said Kurz. “Using these machines really changes the paradigm of how we teach and practice CPR. It’s the idea that my employees get to touch, see and perform high-quality CPR every three months — regardless of their schedule, when they’re working, or which patients they’re treating,” he said. “This is the largest change in our approach in over 60 years and really brings CPR training into the modern era.”
If you are interested in learning more about the RQI program, contact the American Heart Association at RQIquestions@heart.org.