Abstract 110: Application of Manikin-Based Objective Metrics to Evaluate and Improve CPR Instructor-Coordinator Assessment of Learner Chest Compression Performance
Introduction: CPR Instructor-Coordinator (CPR-I/C) adherence to published guidelines during resuscitation and learner assessment for Basic Life Support (BLS) / CPR skills has not been experimentally studied. Investigators sought to 1.) determine the quality of CPR-I/C chest compression and the accuracy of CPR-I/C chest compression assessment, and 2.) improve CPR-I/C compression and assessment skills through cardiac arrest simulations with or without objective in-scenario performance feedback.
Methods: Thirty CPR-I/C’s (20±11 years of BLS provider experience; 11±9 years of BLS instructor experience) were randomized to control or experimental group. Each subject performed compressions during a 2-minute simulation, then reviewed six videos of simulated CPR performances (featuring pre-specified chest compression parameters) for scoring as “Pass” or “Needs Remediation (NR).” Subjects participated in a second simulation with or without real-time manikin compression feedback, then reviewed six additional videos. Primary outcome variables were proportion of subjects with >80% (AHA regional criteria) or >23 of 30 (i.e., 77%; AHA instructor manual criteria) correct compressions, and subjects’ accuracy of “Pass”/“NR” assessment for videos. The secondary outcome variable was correlation between subjects’ correctness of chest compressions and their assessment accuracy for simulated CPR compression performance.
Results: All CPR-I/C subjects compressed suboptimally at baseline; real-time feedback improved the proportion of subjects with >77% correct compressions to 0.53 (p<0.01). Video review data revealed persistently limited CPR-I/C assessment accuracy. Correlation between subjects’ correctness of compressions and their assessment accuracy remained poor regardless of interventions.
Conclusion: Real-time compression feedback during simulation improved CPR-I/C’s chest compression skills without comparable improvement in assessment skills.
- Cardiopulmonary resuscitation
- Healthcare delivery systems
- Patient safety
- Quality of medical care
- © 2012 by American Heart Association, Inc.