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BMC Cardiovascular Disorders
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Open Access 01-12-2023 | Cardiopulmonary Resuscitation | Research

Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators

Authors: Onlak Ruangsomboon, Usapan Surabenjawongse, Pongthorn Jantataeme, Thanawin Chawaruechai, Khemchat Wangtawesap, Tipa Chakorn

Published in: BMC Cardiovascular Disorders | Issue 1/2023

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Abstract

Introduction

In-situ simulation (ISS) is a method to evaluate the performance of hospital units in performing cardiopulmonary resuscitation (CPR). It is conducted by placing a high-fidelity mannequin at hospital units with simulated scenarios and having each unit’s performance evaluated. However, little is known about its impact on actual patient outcomes. Therefore, we aimed to evaluate the association between the ISS results and actual outcomes of patients with in-hospital cardiac arrest (IHCA).

Methods

This retrospective study was conducted by reviewing Siriraj Hospital’s CPR ISS results in association with the data of IHCA patients between January 2012 and January 2019. Actual outcomes were determined by patients’ outcomes (sustained return of spontaneous circulation (ROSC) and survival to hospital discharge) and arrest performance indicators (time-to-first-epinephrine and time-to-defibrillation). These outcomes were investigated for association with the ISS scores in multilevel regression models with hospital units as clusters.

Results

There were 2146 cardiac arrests included with sustained ROSC rate of 65.3% and survival to hospital discharge rate of 12.9%. Higher ISS scores were significantly associated with improved sustained ROSC rate (adjusted odds ratio 1.32 (95%CI 1.04, 1.67); p = 0.01) and a decrease in time-to-defibrillation (-0.42 (95%CI -0.73, -0.11); p = 0.009). Although higher scores were also associated with better survival to hospital discharge and a decrease in time-to-first-epinephrine, most models for these outcomes failed to reach statistical significance.

Conclusion

CPR ISS results were associated with some important patient outcomes and arrest performance indicators. Therefore, it may be an appropriate performance evaluation method that can guide the direction of improvement.
Appendix
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Metadata
Title
Association between cardiopulmonary resuscitation audit results with in-situ simulation and in-hospital cardiac arrest outcomes and key performance indicators
Authors
Onlak Ruangsomboon
Usapan Surabenjawongse
Pongthorn Jantataeme
Thanawin Chawaruechai
Khemchat Wangtawesap
Tipa Chakorn
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2023
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-023-03320-w

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