St. Anthony Regional Hospital and Nursing Home recently implemented Resuscitation Quality Improvement® (RQI), a
groundbreaking new approach to competency-based CPR, and realized these benefits:
- Enhanced staff CPR confidence
- Improved CPR skills dramatically
- Built a more time-efficient means of administering CPR certifications
- Enabled 24/7 access to RQI training resources
- Created a team of unit-based RQI super-users to provide
even more assistance for staff
Katie Towers, Director, Education Services, and Mikala
Landon, Infection Preventionist, shared their experiences
with the recent implementation of RQI via HealthStream.
Basic Life Support (BLS) and Advanced Cardiac Life
Support (ACLS) certifications are work eligibility
requirements for St. Anthony staff, and the organization
takes a hard line on this requirement. The organization has
supported employees with regular access to classes (5 per
month), instructors dedicated to CPR, and sessions that
could last up to two hours if a student needed extensive
resuscitation instruction or much shorter sessions to
simply validate competency.
Prior to instituting RQI, St. Anthony already had a strong
program for BLS and ACLS certification, based on a
structure of instructor-led classes that prepared staff for
resuscitation emergencies. However, when they were
introduced to the patient outcome-favoring value of the
new RQI Program, they found the science to be far too
compelling to ignore.
After learning about RQI, Ms. Towers understood how
students really could develop motor memory in regards to
resuscitation, and that this type of learning really changed
practice and helped develop high-quality skills. Ms. Landon
added that the Voice-Assisted Manikins (VAMs) provide
accurate and immediate feedback. “That was huge for
us.” Ms. Landon points out that in their previous solution,
an instructor visually watching compressions would not
confirm that the speed and depth of compressions were
Ms. Landon shared that some staff members were anxious
about ACLS training and that they worried that the two
year training interval was insufficient to really keep their
skills fresh. It has been confirmed by studies that these skills
actually begin to decay after just six months, well short
of the historical two-year recommendation. With RQI,
learners get more frequent assessments (quarterly) and
are able to develop the confidence to know that they are
performing high-quality CPR.
Without feedback, more
frequent training still isn’t enough. You need both the
training and the feedback. We have seen some dramatic
results. Initially a student might get a score of just 23% and
then see that score increase to as high as 95%. They learn
a lot more and are surprised to see how much they can
improve simply by using the feedback.
Ms. Towers emphasized that this is a rigorous program.
“Learners feel a sense of accomplishment when the
program is finished because they have quantifiable evidence
of their competency. We feel more confident too because
now we have a way to quantify this as well. We’ve seen
dramatic and immediate results. You can see these results
when you observe even one student during one session.
You can see a change in their competency and practice.
This is a differentiator for hospitals to provide this kind of
Ms. Towers and Ms. Landon also shared their process
for introducing RQI. They began by creating buy-in from
nursing leadership. This collaboration helped them to
introduce the new learning process without adding to their
education budget. They trained a team of super-users to
act as additional resources and advocates. These learning
leaders are planning an even larger role for their superusers
in the future and recommend that hospitals begin
their communication process around this training early
and plan for a lot of it. They also recommend promoting
the use of super-users early in the process to share the
responsibility for the rollout.
St. Anthony implemented RQI in early 2016 and does
not yet have metrics to help them quantify the clinical
impact of the more rigorous training. However, as they
continue to roll out RQI they will eventually be able to
review and trend training performance data on a quarterly
basis. They will also have the ability, through the Zoll CPR
Dashboard™ which is built into their CPR electrodes, to
compare training outcomes with detailed CPR quality data.
Ms. Towers and Ms. Landon concluded by saying that in
addition to the clinical education benefits provided by
RQI, they believed that it would also be more efficient and
require less hours of their education department.