Comparison of sudden cardiac arrest resuscitation performance data obtained from in-hospital incident chart review and in situ high-fidelity medical simulation

Kobayashi, Leo; Lindquist, David; Jenouri, Ilse; Dushay, Kevin M; Haze, Donna; Sutton, Elizabeth M.; Smith, Jo; Tubbs, Robert J.; Overly, Frank; Foggle, John; Dunbar-Viveiros, Jennifer A.; Jones, Mark S.; Marcotte, S.; Werner, David L.; Cooper, Martha; Martin, Peggy B.; Tammaro, Dominick; Jay, Gregory D.

doi:10.1016/j.resuscitation.2010.01.003

Cited by 25 publications

(12 citation statements)

References 42 publications

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“…This was congruent with prior investigations,52 53 but with provision for the unique characteristics of ED-practice settings, an emphasis on proactive probing to actively use-test the system,54 55 and minimisation of work-disruptive changes in provider responsibilities. Efforts to engage and familiarise ED staff with telemetry system functions also focused on end-user participation in system revision discussions, equipment in-service sessions, and embedding of system use into routine clinical workflow, for example, placement of prominent data-mirroring displays in clear view of nurse workstations for convenient assistance with chart documentation.…”

Section: Discussionsupporting

confidence: 75%

Use of in situ simulation and human factors engineering to assess and improve emergency department clinical systems for timely telemetry-based detection of life-threatening arrhythmias

et al. 2012

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Background and objectives Medical simulation and human factors engineering (HFE) may help investigate and improve clinical telemetry systems. Investigators sought to (1) determine the baseline performance characteristics of an Emergency Department (ED) telemetry system implementation at detecting simulated arrhythmias and (2) improve system performance through HFE-based intervention. Methods The prospective study was conducted in a regional referral ED over three 2-week periods from 2010 to 2012. Subjects were clinical providers working at the time of unannounced simulation sessions. Three-minute episodes of sinus bradycardia (SB) and of ventricular tachycardia (VT) were simulated. An experimental HFE-based multi-element intervention was developed to (1) improve system accessibility, (2) increase system relevance and utility for ED clinical practice and (3) establish organisational processes for system maintenance and user base cultivation. The primary outcome variable was overall simulated arrhythmia detection. Pre-intervention system characterisation, post-intervention end-user feedback and real-world correlates of system performance were secondary outcome measures. Results Baseline HFE assessment revealed limited accessibility, suboptimal usability, poor utility and general neglect of the telemetry system; one simulated VT episode (5%) was detected during 20 pre-intervention sessions.

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Section: Discussionsupporting

confidence: 75%

Use of in situ simulation and human factors engineering to assess and improve emergency department clinical systems for timely telemetry-based detection of life-threatening arrhythmias

et al. 2012

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“…In combination with chart reviews and patient safety incident reports, these modalities can serve each other as complementary and reduce the risk of misjudgment system performance and lack of recognition of shortcomings as previously proposed [17]. …”

Section: Perspectivesmentioning

confidence: 99%

“…Documentation of resuscitation management may be difficult in the acute situation and it has been reported to be insufficient [15,16]. Furthermore, the retrospective nature of documentation in records represents a pitfall due to incompletion or inaccuracy [17]. Documentation regarding precise timing of events during resusciation, such as data concerning chest compressions and defibrillation, represents a problem and data may be imprecise or not even available [16].…”

Section: Introductionmentioning

confidence: 99%

In-hospital resuscitation evaluated by in situ simulation: a prospective simulation study

Mondrup

Brabrand

Folkestad

et al. 2011

Scand J Trauma Resusc Emerg Med

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BackgroundInterruption in chest compressions during cardiopulmonary resuscitation can be characterized as no flow ratio (NFR) and the importance of minimizing these pauses in chest compression has been highlighted recently. Further, documentation of resuscitation performance has been reported to be insufficient and there is a lack of identification of important issues where future efforts might be beneficial. By implementing in situ simulation we created a model to evaluate resuscitation performance. The aims of the study were to evaluate the feasibility of the applied method, and to examine differences in the resuscitation performance between the first responders and the cardiac arrest team.MethodsA prospective observational study of 16 unannounced simulated cardiopulmonary arrest scenarios was conducted. The participants of the study involved all health care personel on duty who responded to a cardiac arrest. We measured NFR and time to detection of initial rhythm on defibrillator and performed a comparison between the first responders and the cardiac arrest team.ResultsData from 13 out of 16 simulations was used to evaluate the ability of generating resuscitation performance data in simulated cardiac arrest. The defibrillator arrived after median 214 seconds (180-254) and detected initial rhythm after median 311 seconds (283-349). A significant difference in no flow ratio (NFR) was observed between the first responders, median NFR 38% (32-46), and the resuscitation teams, median NFR 25% (19-29), p < 0.001. The difference was significant even after adjusting for pulse and rhythm check and shock delivery.ConclusionThe main finding of this study was a significant difference between the first responders and the cardiac arrest team with the latter performing more adequate cardiopulmonary resuscitation with regards to NFR. Future research should focus on the educational potential for in-situ simulation in terms of improving skills of hospital staff and patient outcome.

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“…32 High-fidelity simulation is useful for assessing the efficacy of the resuscitation teams and even for comparison with the results obtained in real-life CA situations. 33 However, apart from sophisticated equipment, this methodology requires important and careful intervention on the part of the educators, since they must define the concrete skills and the most relevant training strategies, develop appropriate assessment methods, check the validity of the evaluation tests, and consistently evidence the validity of the possible interferences with the assessment methods. 29…”

Section: Performance Reviewmentioning

confidence: 99%

Novelities in resuscitation training methods

López-Messa

Martín-Hernández

Pérez-Vela³

et al. 2011

Medicina Intensiva (English Edition)

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Comparison of sudden cardiac arrest resuscitation performance data obtained from in-hospital incident chart review and in situ high-fidelity medical simulation

Cited by 25 publications

References 42 publications

Use of in situ simulation and human factors engineering to assess and improve emergency department clinical systems for timely telemetry-based detection of life-threatening arrhythmias

Use of in situ simulation and human factors engineering to assess and improve emergency department clinical systems for timely telemetry-based detection of life-threatening arrhythmias

In-hospital resuscitation evaluated by in situ simulation: a prospective simulation study

Novelities in resuscitation training methods

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