Delivering high-quality cardiopulmonary resuscitation in-hospital

Abstract

This review discusses recent data relating to delivering high-quality cardiopulmonary resuscitation (CPR) to patients with in-hospital cardiac arrest. Delivering high-quality CPR requires interventions at a national, local, team and individual rescuer level. These include measuring patient outcomes, patient safety incident reporting, education, an increased emphasis on human factors, briefing and debriefing of resuscitation teams, and the use of sensing devices that provide real-time prompts or feedback to rescuers during CPR. Data from national registries, patient safety incident reports and mock codes can be used to identify areas for improving practice. Education of staff is essential in both technical and nontechnical resuscitation skills (human factors). Resuscitation team performance can be improved by ensuring teams brief and plan beforehand and also debrief using feedback data collected during resuscitation events. The use of feedback and prompt devices helps improve adherence to guidelines for chest compression quality but data are lacking in terms of showing improved patient outcomes. Delivering high-quality CPR in-hospital requires a multifaceted approach. Collecting data during arrests and feeding back in real time and postevent during debriefings can be used to improve delivery of high-quality CPR. There are few studies that show improvement in actual patient outcomes (e.g., survival to hospital discharge) with improvements in delivery of high-quality CPR. Recognizing the importance of both technical and nontechnical skills (human factors) to deliver high-quality CPR is essential.