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Changing Resuscitation Outcomes (Part 2)

April 1, 2021
April 1, 2021

This blog post is based on a webinar featuring Nicole Kupchik, MN, RN, CCNS, CCRN, PCCN-CMC, a Critical Care Clinical Nurse Specialist who is also a well-respected, nationally and internationally-recognized speaker on a variety of emergency and critical care topics.

Reporting To Improve Performance

What are some additional ways in which we can use all of the data that can be delivered by VAMs and the devices used in a code? Kupchik advocates for CPR report cards. The report cards include:

  • Chest compression fraction
  • Compression rate
  • Compression depth

The report can also provide a minute-by-minute evaluation of the event allowing providers to better analyze how to improve chest compression fractions by identifying when compressions stopped, for how long, and why.

Kupchik worked with a group that created provider-specific report cards and posted them on bulletin boards. The group was able to evaluate what caused interruptions in chest compressions and to modify their compression rates and depths, which resulted in substantial improvements to the quality of their CPR by simply using readily available feedback. They also implemented metronomes to ensure that the rate was appropriate and consistent throughout the code.

Team-Based Training and Mock Codes

While quantitative feedback is a great tool in the drive towards high-quality CPR, training is critical, too. Kupchik points to the job of the first responder, which is essentially to start chest compressions, activate the code blue and hospital-wide response, get the crash cart to the bedside, and open the airway.

Mock codes help to quantify whether high quality CPR is happening or not, but it can also shine the light on staff behaviors and answer questions, such as:

  • Did all of the required staff respond?
  • Was the bedside nurse readily available to brief the patient history?
  • Did staff observe isolation procedures, if necessary?

Lastly, Kupchik reiterated that poor-quality CPR is a source of preventable harm to patients. Regular training and performance-related feedback can help minimize this particular source of preventable harm.

Incorporating metrics from VAMs and other devices into post-event feedback can build both skills and confidence in skills.