Abstract
BackgroundIn-hospital cardiac arrests (IHCA) occur commonly and are associated with poor survival and variable outcomes. This study aimed to directly survey IHCA responders to understand their perceptions of resuscitation care.MethodsAs part of a quality improvement initiative, we surveyed participating providers of IHCAs at our institution from Jan 2014 to May 2016. The survey included unstructured free text feedback, which was the focus of this study. We systematically coded the free text and organized identifiable latent themes using thematic analysis.We used the natural timeline of an IHCA – pre-arrest, arrest, and post-arrest – for organization of the identifiable latent themes, and created a separate category for holistic remarks that arched across the timeline.ResultsWe identified 172 IHCAs with a mean of 1.7 responses per arrest (range: 1–8 responses). The mean age of this patient population was 59 years at the time of arrest, and 107 (62%) were men.We identified several themes - [1] issues around code activation and code status characterized the pre-arrest period [2] ,team interactions and issues around supplies/equipment dominated the intra-arrest period, and [3] code cessation and transitions of care typified the post-arrest period. Holistic remarks focused on attentiveness paid by the arrest team to patient comfort and family. Some comments reflected positive experiences but most focused on areas of improvement consistent with the initiative’s purpose. In certain cases, we identified a tension between the need to balance established resuscitation protocols with flexibility required by real-life circumstances.ConclusionsDirectly surveying those who participated in IHCAs led to novel insights about their experiences. Our findings suggest that parsing through such qualitative feedback can help hospitals identify areas of improvement, modulate expectations, temper emotions, and refine protocols.
Highlights
In-hospital cardiac arrests (IHCA) occur commonly and are associated with poor survival and variable outcomes
No previous study has systematically asked a broad range of IHCA first-responders across multiple disciplines about their experiences with resuscitation care to directly capture their perceptions on performance
We used the natural timeline of an IHCA – prearrest, arrest, and post-arrest – for organization of the identifiable latent themes, and created a separate category for holistic remarks that arched across the timeline
Summary
In-hospital cardiac arrests (IHCA) occur commonly and are associated with poor survival and variable outcomes. No previous study has systematically asked a broad range of IHCA first-responders across multiple disciplines about their experiences with resuscitation care to directly capture their perceptions on performance. This is an important gap for two reasons. IHCA is a complex clinical process that involves team members who often do not know each other prior to arrival at a cardiac arrest [11, 12] Under such emergency circumstances, success does not rely so much on the performance of an individual provider as it does the overall interactions of multiple providers and the system [13]. Information on the perceptions of global operations of a resuscitation team could lead to novel insights
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
