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Frequent Practice and Real-Time Feedback are Keys to Improved Resuscitation

April 1, 2021
April 1, 2021

This blog post excerpts an article by Marnie Kelly, MBA; Vice President, Healthcare Workforce Solutions, HealthStream, in the Q3 2015 issue of PX Advisor, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.

 

In our feature article this quarter, HealthStream takes a look at the practice of resuscitation. Many of us have perceptions from popular television shows that resuscitation is almost always effective; however, the truth is that we are really not as good at resuscitating as you might think. Currently, we are only able to revive about 19% of those with in-hospital cardiac arrest.

New research from the American Heart Association and others is showing that more frequent CPR training is needed in our healthcare organizations and that real-time feedback using voice-assisted manikins can greatly improve students’ skills at resuscitation. Even long-time CPR instructors have been shocked to discover that they do not pass tests incorporating the more sophisticated tools that can be leveraged to measure performance. 

Most hospitals in the U.S. use traditional classroom instruction to train employees in CPR, with only about 30% making the switch to the American Hear t Association’s HeartCode program that includes online instruction coupled with practice using Voice-Assisted Manikins. Those who have made the upgrade have seen improvements in CPR quality, code response rates, and employee confidence and competence. The American Heart Association’s Resuscitation Quality Improvement (RQI) program is the next generation of this training. By breaking the learning that is typically required every two years into short quarterly modules, learners are proving to have higher retention and patient survival rates.

Here we look at the latest available research on resuscitation and talk with Resuscitation Scientist, Associate Professor, and Emergency Medicine Specialist Dr. Michael Kurz about his experiences at the University of Alabama-Birmingham.

Cardiac Arrest is a Leading Cause of Death

Internationally, more than 135 million cardiovascular deaths occur each year, and this number is increasing. Across the globe, for every 100,000 people, cardiac arrests range from 20-140 people. Unfortunately, survival rates are low and range from 2 – 11 %.

In the U.S., survival rates are slightly higher but still less than 15%. Cardiac arrest is a leading killer in the U.S. “claiming more lives than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, auto accidents, HIV, firearms, and house fires combined”.

Even in hospital settings, survival rates are surprisingly low and typically range from 15 – 20%. Interestingly, there is a difference in survival rate based on the time of day that the arrest occurs. For example, there is a 20% survival rate if the arrest occurs between 7 AM and 11 PM. However, the survival rate drops to 15% if the arrest occurs between 11 PM and 7 AM. Meany et al. also reported that there is a survival difference based on the interaction between location in the hospital and time of the arrest. There is only a 9% survival rate if the arrest occurs in an unmonitored setting at night. The rate increases to about 37% if the arrest occurs during the day in the operating room or a post-anesthesia unit. Clearly, there is an opportunity in the U.S. healthcare system to reduce variation and improve overall survival rates from cardiac arrest.