Abstract 209: Evaluation of Quantitative Debriefing After Cardiac Arrest
Introduction: Debriefing after adult cardiac arrest is effective to improve CPR quality and survival outcomes. A rigorous investigation of pediatric resuscitation debriefing programs has not been done.
Objective: To describe and evaluate a multidisciplinary, peer-led, pediatric cardiac arrest quantitative debriefing (QD) program. We hypothesized that QD would improve knowledge, confidence, and competence to perform high quality pediatric resuscitation.
Methods: Physician-led 60 minute multidisciplinary QDs were conducted using downloaded data from CPR recording defibrillators/central monitors and forensic engineering analysis. Following each QD, attendees completed a semi-quantitative survey. Eight QD content elements divided, a priori, into chest compression (CC) related (e.g. no flow time, CC quality, end tidal CO2, defibrillation) and non-CC related (e.g. communication, rhythm recognition, medications, arrest physiology) categories were evaluated to determine those most useful overall (5- point Likert scale: 1 = very useful / 5 = not useful). Summary scores of each category were then calculated to evaluate their impact on providers' knowledge, confidence, and competence. Analysis by Wilcoxon rank sum test.
Results: Between June 2010 and May 2011, 6 QDs were completed within 21 ± 13 days of the cardiac arrest. Thirty-four of 50 (68%) front line care providers were able to attend the QD and complete surveys: RN (15%), attending MD (35%), fellow MD (26%), resident MD (9%), ECMO (6%), and RT (9%). Thirty-four (100%) reported improved knowledge and performance; 33/34 (97%) noted improved confidence. QD content had an average overall usefulness score of 1.5 ±1.0. CC related items scored higher than non-CC related items to improve knowledge (1.9 ± 1.1 vs. 1.3 ± 1.2; p<0.02) and performance (2.1 ± 1.1 vs. 1.0 ± 1.2; p<0.01).
Conclusions: A novel Quantitative Debriefing (QD) program improved self-reported knowledge, confidence, and competence to perform high quality pediatric resuscitation. CC related QD elements were rated more useful than non-CC related elements. Future studies are planned to measure and evaluate actual clinical performance impact of QD programs.
- © 2011 by American Heart Association, Inc.