No abstract

Background: High quality CPR is critical for survival from cardiac arrest. However, for many providers the opportunity to perform CPR, whether in a training or a clinical situation, is too infrequent to maintain proficiency. Low dose- high frequency case based simulation has been proposed as a method to maintain proficiency for low volume, high-risk medical procedures. We sought to evaluate the feasibility and compliance with a novel low dose- high frequency case based psychomotor cardiopulmonary resuscitation training at a mobile simulation station in an in-hospital setting (Resuscitation Quality Improvement™ (RQI), American Heart Association, Dallas, TX). Methods: The RQI system was piloted on two nursing units in a university teaching hospital. The Simulation station was placed in the nursing units with quarterly activities integrated into normal clinical duties. Evaluation of the system focused on staff compliance and evaluation of CPR quality metrics of compression (depth, rate, and release) and ventilations (tidal volume, rate adequacy). Descriptive statistics are presented as means with standard deviations. Results: The program was launched in October 2014 with 100 nurses enrolled. Program compliance with last quarter 2014 and first quarter 2015 were 97.1% and 97.2%, respectively. Lack of compliance was due primarily to medical leave exemptions with 1 delinquent participant per quarter. Mean compression depth was 53 ± 3 mm; mean compression rate of 110 ± 9 cpm; percent of adequate compressions of 96 ± 4%; and percent of adequate release of 99 ± 1%. Ventilation data demonstrated mean tidal volumes of 521 ± 69 ml; mean ventilation rates of 11 ± 2 bpm; and percent of adequate ventilations of 85 ± 18%. Conclusions: Low dose- high frequency case based psychomotor cardiopulmonary resuscitation training is a feasible method to enhance CPR skill retention in the hospital setting. Program compliance was high through two quarters of training. Performance metrics demonstrate high quality CPR after 2 quarters of exercises indicating CPR skill retention. Further research is necessary to evaluate skill retention over longer periods and the program’s effect on clinical outcome variables.