Search

The article focuses on a study which evaluated the association between automated external defibrillators (AEDs) use and survival for in-hospital cardiac arrest. The researchers examined 11,695 hospitalized patients who experienced cardiac arrests between January 1, 2000 to August 26, 2008 at U.S. hospitals following the introduction of AEDs on general and hospital wards. Study results indicated that hospitalized patients with cardiac arrest and use of AED were not associated with improved survival.

Introduction: Targeted temperature management (TTM) is recommended for cardiac arrest patients. Successful implementation of a TTM protocol depends on the nurses' knowledge and skills. The study's aim was to compare the level of knowledge, psychomotor skills, confidence and satisfaction before, immediately after and at 6 weeks after training nurses on the delivery of TTM with video lecture versus video lecture and high fidelity simulation., Method: Demographic variables were compared across treatment groups using t-tests and Chi-square tests. Change over 6 weeks after intervention was tested with mixed effects model., Results: Fifty-two registered nurses were enrolled. Knowledge test scores, the primary outcome, did not differ between the groups immediately after the training (beta = 3.80, SE = 3.47, p = .27), but there was a strong trend 6 weeks after the training in favor of simulation (beta = 7.93, SE = 3.88, p = .04). Skills were significantly better immediately after the training in the simulation group, but no different 6 weeks later. No difference in confidence was found at either post-test point. Simulation-trained nurses were more satisfied with their training at both post-testing points., Conclusion: In this study of training approaches to TTM after cardiac arrest, nurses trained with video lecture and high fidelity simulation benefitted from this approach by maintaining their TTM knowledge longer., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals., Objective: To describe current US hospital practices with regard to resuscitation care., Design: A nationally representative mail survey., Setting: A random sample of 1000 hospitals from the American Hospital Association database, stratified into 9 categories by hospital volume tertile and teaching status (major teaching, minor teaching, and nonteaching)., Subjects: Surveys were addressed to each hospital's cardiopulmonary resuscitation (CPR) committee chair or chief medical/quality officer., Measurements: A 27-item questionnaire., Results: Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (P = 0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a hospitalist. High frequency practices included having a rapid response team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least 1 barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common., Conclusions: There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement., (© 2014 Society of Hospital Medicine.)

The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient's response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

The International Liaison Committee on Resuscitation (ILCOR) was formed in 1992 to provide a forum for resuscitation organizations worldwide. According to its mission, ILCOR provides a mechanism by which international science and knowledge that are relevant to cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) can be identified, reviewed, and evaluated. Every 5 years, based on a rigorous review of the published, peer-reviewed science, ILCOR develops a consensus on resuscitation science and carries that forward into internationally agreed-on treatment recommendations. As part of the 2010 evidence-evaluation process, ILCOR published an updated consensus on science and treatment recommendations (CoSTR). Based on the CoSTR, the American Heart Association (AHA) developed and disseminated guidelines for ECC and CPR. Nursing has unique responsibilities in the chain of survival. This article reviews the major elements of AHA's 2010 guidelines and discusses the critical role that nurses play in the development, dissemination, and implementation of resuscitation science. By making the connection in resuscitation science, nurses can help to save more lives., (© 2011 The Author. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.)

Optimizing the links in the Chain of Survival improves outcomes and saves lives. The use of evidence-based education and implementation strategies will allow organizations and communities to strengthen these links in the most effective and efficient manner.

Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.

Background: Data suggest that the overall quality of inhospital resuscitation is suboptimal and contributes to poor patient outcomes. In 2000 the American Heart Association created the National Registry of Cardiopulmonary Resuscitation (NRCPR) as an evidence-based hospital safety program. Participating hospitals voluntarily join the registry and pay an annual fee that includes data support and report generation. The primary purpose of NRCPR is to support local facility efforts in practice management and performance improvement (PI)., Chain of Survival: The Chain of Survival illustrates the series of critical, interdependent actions necessary to maximize patient outcome from sudden cardiac arrest--early access to the emergency response system, early cardiopulmonary resuscitation (CPR), early defibrillation, and early advanced cardiovascular care. NRCPR specifically addresses each link and helps hospitals develop, implement, and monitor their resuscitation processes in a manner that builds on available evidence., Participation in Nrcpr: On enrollment into NRCPR, each hospital identifies an onsite coordinator who is instructed on a standardized method for abstracting data from patient charts and how to enter data into the NRCPR database. The NRCPR database is managed centrally and provides participating organizations with ongoing, quarterly, and annual reports related to their resuscitation events., Discussion: NRCPR is used as both a local PI tool as well as a source of data that scientists are analyzing to further the understanding of inhospital resuscitation processes and outcomes. Over time, researchers have recognized the need to refine the Chain of Survival to reflect the unique aspects of inhospital resuscitation. A rapid response system provides a new link at the beginning, and postresuscitation care provides a new link at the end of the Chain of Survival.

A multitrait, multimethod approach was used to evaluate the validity of a hospital-based nurse competency assessment program as a mechanism for assuring compliance with the three standards for competence established by the National Council of State Boards of Nursing, Inc. For selected competencies, both knowledge and skill performance were evaluated under simulated conditions and under routine patient care conditions. Under simulated conditions, pass rates on first attempts among the 368 participating nurses were high as expected (82 per cent to 94 per cent on knowledge and 75 per cent to 99 per cent on performance). Offering immediate educational feedback followed by second attempts yielded a 97 per cent overall pass rate. Competencies assessed under both simulated and patient care conditions (35 sets of observations) revealed no differences in assessed competence. The equivalence of assessments made under simulated and patient care conditions supports the validity of competency assessment programs currently in use in many large health care settings., (Copyright 2002 by W.B. Saunders Company)