Teamwork During Cardiopulmonary Resuscitations at a Rural Minnesota Hospital
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Abstract
Cardiac arrest is a major public health problem affecting thousands of individuals each
year in both out-of-hospital and in-hospital settings (Sutton, Nadkarni, & Abella, 2012). In 2012
nearly 383,000 out-of-hospital sudden cardiac arrests occurred and approximately 209,000
cardiac arrests occurred within a hospital (American Heart Association, 2012). Survival rates
from cardiac arrest are improving, however overall rates of survival are still low (American
Heart Association, 2012).
The purpose of this project was to enhance the teamwork, knowledge, and technical skills
of all individuals involved in cardiopulmonary resuscitations at the project site. Expectations of
the project were to (1) enhance cardiopulmonary resuscitation knowledge by providing evidencebased
resources to team members, (2) clearly delineate roles of team members during
resuscitations, and (3) develop a continuing education plan that will ensure the maintenance of
quality cardiac resuscitations.
A survey to assess the needs of the cardiac resuscitation team members was distributed to
all providers at the project site as well as all staff registered nurses, pharmacists, respiratory
therapists, nurse anesthetists, and hospital unit coordinators. The survey results identified the
nurses’ perception that the providers lack leadership skills during resuscitations. Many survey
responses noted confusion about the role of each individual during resuscitations. Nurses felt
lack of confidence in knowledge of medications, as well as mixing and titration of medications.
Based on feedback from the survey, six mock resuscitation/simulations were facilitated
utilizing four scenarios that were developed. Following each mock resuscitation/simulation, a
debriefing occurred utilizing a debriefing tool. A post mock resuscitation survey was
administered at the completion of the project. Eleven surveys were returned. Results of the
project were overall positive. Evidence based resources were developed and utilized by providers
and nursing during both mock and actual resuscitations. Posters were developed and placed in
the emergency department that clearly delineated each participant’s role. A continuing education
plan based upon feedback from a post resuscitation survey was developed. The continuing
education plan includes having mock resuscitations/simulations once per month at various times
of the day to accommodate all staff.