Abstract 257: Perceptions of Inadequate Resuscitation Preparedness Within ACLS-Certified Emergency Medicine Residents and Nurses
Background: The quality of cardiopulmonary resuscitative efforts is suboptimal in the setting of in-hospital cardiac arrests and unsupervised internal medicine residents often feel unprepared to lead resuscitation efforts. Little is known about how emergency medicine residents and nurses (EM providers) perceive their competence and preparedness regarding arrest resuscitations in the emergency department, where resuscitations are supervised and staff are familiar with each other and resuscitation equipment.
Objectives: We aimed to determine EM providers' sense of preparedness to lead cardiac arrest resuscitations and how they judge the quality of their performance and perceive the adequacy of feedback and training they receive.
Methods: We conducted an online survey of EM providers at an urban teaching hospital between March and April 2010. Participants were queried about perceived resuscitation performance and training as well as event debriefing.
Results: Of the128 EM providers surveyed, 25 (64%) residents and 55 (62%) nurses completed the survey. All were ACLS certified. Most respondents, 78% (62/80), participated in 1 to 5 resuscitations per month. Only 44% (11/25) of residents and 62% (34/55) of nurses felt prepared to lead a resuscitation event, yet leadership was valued as the most important determinant of the quality of resuscitative efforts. Many, 56% (14/25), residents felt overwhelmed leading a resuscitation and 76% (19/25) worried they had made a mistake during a cardiac arrest resuscitation. Only 36% (9/25) of residents and 44% (24/55) of nurses thought the ACLS course provided sufficient training to lead a cardiac arrest team; and no residents (0/25) and only 11% (6/55) of nurses felt it contributed most to their sense of preparedness. Most residents, 96% (24/25), and nurses, 85% (47/55), felt it was important to receive debriefing after an arrest resuscitation, yet 64% (16/25) of residents and 65% (36/55) of nurses indicated that they rarely or never did.
Conclusions: Many ACLS-certified EM providers feel ill-prepared to lead cardiac arrest resuscitations. Future work is needed to determine how to best improve EM providers' preparedness to lead the care of patients in cardiac arrest.
- © 2010 by American Heart Association, Inc.