137: AUTOMATE TO RESUSCITATE: OUTCOMES OF MECHANICAL CPR TWO YEARS AFTER ACUTE CARE IMPLEMENTATION

Abstract

Introduction: Expert Guidelines endorsed Mechanical Cardiopulmonary Resuscitation (mCPR) devices in response to the COVID-19 pandemic. In April, 2020, a regional hospital received grant-funding for mCPR devices to reduce team exposure during CPR events. Methods: We aimed to evaluate patient outcomes and teammate perceptions associated with mCPR. The primary clinical outcome measured was 1 hour survival post CPR event among inpatients experiencing a cardiopulmonary arrest before & after mCPR implementation, including subset analysis of CPR events where mCPR was specifically noted as being used. Teammate perceptions comparing resuscitation events with and without the mCPR device, barriers to use, and impact on communication and teamwork were assessed using an electronic survey approximately one year post-implementation. Results: Respondents to the team survey (n=22) were primarily nurses (81%) in the critical care unit or the critical care code team, Respiratory Therapists (9.5%) & physicians or APPs (9.5%). One third of participants self-reported using the mCPR device 60% or more of the time. Most (72%) indicated a reduction in teammates required in the room for CPR events in the ICU. Participants rated improvement in communication and ability to focus on their role during a Code Blue. Most (76%) “Agreed” or “Strongly Agreed” that the quality of resuscitation is improved when the mCPR is in use. We defined event survival as return of spontaneous circulation (ROSC) plus survival >1 hour after the CPR event to align with historic institutional data. Baseline survival (2019) at 1 hour across all inpatient areas was 53.1%. During the 2 years post-implementation, inpatient event survival was similar at 52.9% with confirmed mCPR. In critical care, post implementation non-mCPR codes had 54.2% survival compared with 57.14% confirmed mCPR ICU Codes. mCPR was documented only in about 8% of ICU and non-ICU codes. Data are limited by onconsistent documentation of mCPR Utilization. Measures were implemented May 1 2022 and following to better capture utilization. Conclusions: Staff report benefits with mCPR. mCPR outcomes should be monitored as a variable in ongoing quality improvement. Further study of quantitative outcomes with subgroup analysis & staff perception of mCPR devices in inpatient CPR events is needed.