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

被引：18

作者：

Kobayashi, Leo ^{[1
,2
]}

Lindquist, David G. ^{[1
,2
]}

Jenouri, Ilse M. ^{[1
,2
]}

Dushay, Kevin M. ^{[3
]}

Haze, Donna ^{[4
]}

Sutton, Elizabeth M. ^{[1
,2
]}

Smith, Jessica L. ^{[1
,2
]}

Tubbs, Robert J. ^{[1
,2
]}

Overly, Frank L. ^{[1
,2
]}

Foggle, John ^{[1
,2
]}

Dunbar-Viveiros, Jennifer ^{[1
,4
]}

Jones, Mark S. ^{[1
]}

Marcotte, Scott T. ^{[1
]}

Werner, David L. ^{[5
]}

Cooper, Mary R. ^{[6
]}

Martin, Peggy B. ^{[6
]}

Tammaro, Dominick ^{[7
]}

Jay, Gregory D. ^{[1
,2
,8
]}

机构：

[1] Rhode Isl Hosp, Med Simulat Ctr, Providence, RI 02903 USA

[2] Brown Univ, Alpert Med Sch, Dept Emergency Med, Providence, RI 02903 USA

[3] Brown Univ, Alpert Med Sch, Div Pulm Crit Care & Sleep Med, Dept Med,Rhode Isl Hosp, Providence, RI 02903 USA

[4] Rhode Isl Hosp, Dept Nursing, Providence, RI 02903 USA

[5] Univ Nevada, Sch Nursing, Las Vegas, NV 89154 USA

[6] Lifespan, Providence, RI 02903 USA

[7] Brown Univ, Alpert Med Sch, Rhode Isl Hosp, Div Internal Med,Dept Med, Providence, RI 02903 USA

[8] Brown Univ, Alpert Med Sch, Dept Bioengn, Providence, RI 02912 USA

来源：

RESUSCITATION | 2010年 / 81卷 / 04期

关键词：

Emergency treatment; Health care quality improvement; Medical emergency team; Microsystem; Research; Resuscitation; Simulation; Sudden cardiac death; LONG-TERM OUTCOMES; CARDIOPULMONARY-RESUSCITATION; VENTRICULAR-FIBRILLATION; SHOULDER DYSTOCIA; LIFE-SUPPORT; DEFIBRILLATION; SURVIVAL; QUALITY; SAFETY; CHAIN;

D O I：

10.1016/j.resuscitation.2010.01.003

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: High-fidelity medical simulation of sudden cardiac arrest (SCA) presents an opportunity for systematic probing of in-hospital resuscitation systems. Investigators developed and implemented the SimCode program to evaluate simulation's ability to generate meaningful data for system safety analysis and determine concordance of observed results with institutional quality data. Methods: Resuscitation response performance data were collected during in situ SCA simulations on hospital medical floors. SimCode dataset was compared with chart review-based dataset of actual (live) in-hospital resuscitation system performance for SCA events of similar acuity and complexity. Results: 135 hospital personnel participated in nine SimCode resuscitations between 2006 and 2008. Resuscitation teams arrived at 2.5 +/- 1.3 min (mean +/- SD) after resuscitation initiation, started bag-valve-mask ventilation by 2.8 +/- 0.5 min, and completed endotracheal intubations at 11.3 +/- 4.0 min. CPR Was performed within 3.1 +/- 2.3 min; arrhythmia recognition occurred by 4.9 +/- 2.1 min, defibrillation at 6.8 +/- 2.4 min. Chart review data for 168 live in-hospital SCA events during a contemporaneous period were extracted from institutional database. CPR and defibrillation occurred later during SimCodes than reported by chart review, i.e., live: 0.9 +/- 2.3 min (p < 0.01) and 2.1 +/- 4.1 min (p < 0.01), respectively. Chart review noted fewer problems with CPR performance (simulated: 43% proper CPR vs. live: 98%, p < 0.01). Potential causes of discrepancies between resuscitation response datasets included sample size and data limitations, simulation fidelity, unmatched SCA scenario pools, and dissimilar determination of SCA response performance by complementary reviewing methodologies. Conclusion: On-site simulations successfully generated SCA response measurements for comparison with live resuscitation chart review data. Continued research may refine simulation's role in quality initiatives, clarify methodologic discrepancies and improve SCA response. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：463 / 471

页数：9

共 5 条

[1] High-fidelity simulation fails to improve clinical performance in a randomized study of actual in-hospital cardiac resuscitation
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[2] In Situ Simulation Comparing In-Hospital First Responder Sudden Cardiac Arrest Resuscitation Using Semiautomated Defibrillators and Automated External Defibrillators
Kobayashi, Leo
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[J]. SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE, 2010, 5 (02): : 82 - 90
[3] Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators
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[4] Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators
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[5] Extended cardiopulmonary resuscitation: from high fidelity simulation scenario to the first clinical applications in Poznan out-of-hospital cardiac arrest program
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