Best Practices for Education and Training of Resuscitation Teams for In-Hospital Cardiac Arrest

Anderson, T.M et al. Circulation. 2021

Importance of Conclusion

Each year in the United States, approximately 292,000 adult patients suffer an in-hospital cardiac arrest (IHCA) with significant variation in their survival rate. This study identifies four themes related to training and education among top-performing hospitals excelling in IHCA survival; engagement, clear communication, consistency, and responsive leadership. Developing tools to expand these areas for hospitals may improve IHCA outcomes.

Key Points

  • Engagement: top-performing hospitals use engagement through multiple domains:
    • Marketing new initiatives and incorporating slogans to highlight relevant information
    • Use of visual abstracts and posters for concise messages in readily accessible locations
    • Recognition of the importance of clinical duties and implementing mock codes within a reasonable time-frame (i.e. 20 minutes or less)
    • Prioritization of hands-on learning across disciplines and relevant curriculum with real-world and plausible simulations
    • Better engagement with mock codes highlights larger system flaws, resulting in proactive policy and structural changes to improve patient safety
  • Consistency: top-performing hospitals use consistency as a cornerstone to employee development:
    • Treating mock code training as a core job responsibility vs a supplemental task
    • Maintaining consistency in code sessions with routine practice (i.e. quarterly or even 2 x month)
    • Investing in facilitator training to create a uniformed experience in learning so that mock codes are consistent
  • Clear Communication: top-performing hospitals demonstrate clear communication in multiple ways:
    • Thoroughly communicating to employees the value and importance of education and training to improve IHCA outcomes
    • Debriefing in interdisciplinary settings (i.e. nurses and physicians) with the goal of debriefing immediately after a mock code
    • Implementation of code committee reviews or via admins to review and disseminate code data
    • Re-education and emphasis on continued iterative improvement with clear messaging of how performance can be improved
  • Responsive Leadership: top-performing hospitals distinguish themselves with supportive leadership:
    • Personal interaction and visibility by supervisors to build trust with nurses, physicians and floor staff
    • Leadership directly addressing resistance to participating in mock codes by providing perspective on the shared value of continued education and training
    • Continuous review and adjustment to curriculum, being adaptive to the needs of learners (i.e. being able to identify specific areas of improvement and sustainable solutions)
    • Leadership fostering multidisciplinary collaboration and emphasizing the value of an integrated approach to training

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