Abstract
BackgroundAdult and paediatric basic life support (BLS) training are often conducted via group training with an accredited instructor every 24 months. Multiple studies have demonstrated a decline in the quality of cardio-pulmonary resuscitation (CPR) performed as soon as 3-month post-training. The ‘Resuscitation Quality Improvement’ (RQI) programme is a quarterly low-dose, high-frequency training, based around the use of manikins connected to a cart providing real-time and summative feedback. We aimed to evaluate the effects of the RQI Programme on CPR psychomotor skills in UK hospitals that had adopted this as a method of BLS training, and establish whether this program leads to increased compliance in CPR training.MethodsThe study took place across three adopter sites and one control site. Participants completed a baseline assessment without live feedback. Following this, participants at the adopter sites followed the RQI curriculum for adult CPR, or adult and infant CPR. The curriculum was split into quarterly training blocks, and live feedback was given on technique during the training session via the RQI cart. After following the curriculum for 12/24 months, participants completed a second assessment without live feedback.ResultsAt the adopter sites, there was a significant improvement in the overall score between baseline and assessment for infant ventilations (N = 167, p < 0.001), adult ventilations (n = 129, p < 0.001), infant compressions (n = 163, p < 0.001) adult compressions (n = 205, p < 0.001), and adult CPR (n = 249, p < 0.001). There was no significant improvement in the overall score for infant CPR (n = 206, p = 0.08). Data from the control site demonstrated a statistically significant improvement in mean score for adult CPR (n = 22, p = 0.02), but not for adult compressions (N = 18, p = 0.39) or ventilations (n = 17, p = 0.08). No statistically significant difference in improvement of mean scores was found between the grouped adopter sites and the control site. The effect of the duration of the RQI curriculum on CPR performance appeared to be minimal in this data set. Compliance with the RQI curriculum varied by site, one site maintained hospital compliance at 90% over a 1 year period, however compliance reduced over time at all sites.ConclusionsThis data demonstrated an increased adherence with guidelines for high-quality CPR post-training with the RQI cart, for all adult and most infant measures, but not infant CPR. However, the relationship between a formalised quarterly RQI curriculum and improvements in resuscitation skills is not clear. It is also unclear whether the RQI approach is superior to the current classroom-based BLS training for CPR skill acquisition in the UK. Further research is required to establish how to optimally implement the RQI system in the UK and how to optimally improve hospital wide compliance with CPR training to improve the outcomes of in-hospital cardiac arrests.
Highlights
Adult and paediatric basic life support (BLS) training are often conducted via group training with an accredited instructor every 24 months
The relationship between a formalised quarterly Resuscitation Quality Improvement’ (RQI) curriculum and improvements in resuscitation skills is not clear. It is unclear whether the RQI approach is superior to the current classroom-based BLS training for cardiopulmonary resuscitation (CPR) skill acquisition in the UK
Further research is required to establish how to optimally implement the RQI system in the UK and how to optimally improve hospital wide compliance with CPR training to improve the outcomes of in-hospital cardiac arrests
Summary
Adult and paediatric basic life support (BLS) training are often conducted via group training with an accredited instructor every 24 months. Multiple studies have demonstrated a decline in the quality of cardiopulmonary resuscitation (CPR) performed as soon as 3-month post-training. High-quality cardiopulmonary resuscitation (CPR) is critical for patient survival during a cardiac arrest, providing manual circulation of oxygenated blood while any reversible causes of the cardiac arrest are identified and treated [1]. Training for cardiac arrests present an important and acute challenge for healthcare professionals (HCPs) and hospital organisations. High-quality CPR includes appropriate rate, depth, and chest recoil for adult CPR, as well as appropriate ventilation for paediatrics. It has been reported by previous studies that high-quality chest compressions do not occur in 36–87% of in-hospital CPR [3,4,5]
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