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blog post 08042016

Hospital Changes Approach To Resuscitation Training to Improve CPR Outcomes

In 2010, the American Heart Association (AHA) recommended a move to more frequent training and assessment of CPR skills. Historically, the skill has been taught and evaluated every two years. However, recent research has shown that the psychomotor skills used in CPR actually begin to decay within three to six months. Because poor CPR skills can lead to episodes of preventable harm to patients, the AHA has set a goal of increasing “Sudden Cardiac Arrest (SCA) survival-to-discharge rates from 19% to 38% by 2020.” Given the rapid decay of CPR skills, hospitals are left with a rather significant challenge—how to preserve resuscitation skills and insure that patients are receiving optimal care. The research suggests a need for much more frequent CPR training. What is the best way to insure that patient care providers are getting the recommended training at the recommended interval? Illinois Valley Community Hospital (IVCH) has solved this problem with an innovative solution from AHA. In January, they were the first hospital in Illinois to implement the RQI Program.

SITUATION

Renee Rebholz, IVCH’s Director of Education, recently shared her experience and that of IVCH with the implementation and introduction of RQI. Like most of her colleagues at small, rural hospitals, Ms. Rebholz works hard to insure that IVCH’s 700 employees receive the training and certifications that they need and shared with us that in the past, “It was very hard to maintain competency and make sure that patient care staff had unexpired CPR cards. The size of the hospital staff made training difficult—it was a challenge to provide coverage on the nursing units and departments while trying to provide the training every two years and the necessity of providing it on a more frequent basis seemed a daunting task.” Ms. Rebholz also noticed something that new AHA Guidelines and research have quantified—“our staff felt as if they weren’t skilled enough because (with the exception of the ER and the ICU) they weren’t using the skills often enough during the two-year training intervals. There was a level of learning that we were losing and we could see it during the training.”

RESULTS

While it is still too early to quantify clinical results (the program began in January 2016), IVCH has surveyed the program’s participants in an attempt to measure program efficacy and acceptance of the new training modality. Acceptance for the program is extraordinarily high, but Ms. Rebholz shared that many nurses were actually shocked to learn that they had been doing compressions incorrectly. “This allows all patient care staff to have a comfort level that they are doing CPR correctly—they know because they’ve just done it. People believe that this is going to make them better at this skill. It provides them with the insight to do it better every time. They changed how they did compressions and said that ventilations were more of a challenge than they thought it would be and that more practice meant a higher comfort level,” said Ms. Rebholz.

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