Optimizing Nursing Response to In-Hospital Cardiac Arrest Events Using In Situ Simulation

Background: In-hospital cardiac arrests (IHCA) in the United States have a 21% survival-to-hospital discharge rate. This quality improvement project aimed to improve Basic Life Support–trained nursing staff responses to IHCAs at a large academic teaching hospital. Methods: Thirty-six nursing staff members were included in this pre–post design quality improvement project. A preintervention survey was administered to assess role confidence during IHCAs before implementation. A baseline 5-minute cardiac arrest simulation occurred on the nursing unit where time to interventions and quality of cardiopulmonary resuscitation data points were collected. The baseline simulation concluded with a 5-minute debrief then a repeat 5-minute cardiac arrest simulation occurred. A postintervention survey was completed to measure role confidence after implementation. Results: The mean time to task completion significantly decreased (p < .05) for 75% of tasks. There were no statistically significant changes in the quality of chest compressions. Respondents ranked seven of nine confidence questions with a significant increase in confidence from preconfidence to postconfidence surveys (p < .05). Conclusion: Immediate action and resuscitation skill proficiency is essential to reduce morbidity and mortality resulting from an IHCA. In situ simulation on nursing units is an evidence-based method to maintain and reinforce resuscitation skills needed in the event of an actual patient crisis.

Duke Scholars

Author Virginia Chris Simmons School of Nursing