Pediatric Resident University of New Mexico Children's Hospital ALBUQUERQUE, New Mexico, United States
Background: The survival of pediatric patients requiring cardiopulmonary resuscitation (CPR) for cardiopulmonary arrest (CPA) is largely dependent on optimal and timely resuscitation in concordance with professional resuscitation guidelines. Studies in pediatric settings have been completed showing improvement of CPR performance using simulations (SIMs). However, despite these interventions, creating an environment in which Pediatric Emergency Department (PED) personnel are prepared to provide optimal CPR remains challenging. Objective: The objective is to optimize systems-based practices to improve the care of pediatric CPA patients by identifying and addressing barriers to providing ideal CPR in a PED setting. Design/Methods: This study utilizes quality improvement (QI) methodology PDSA cycles to demonstrate the feasibility of scheduled, standardized, in-situ simulations of CPR events in the PED. PDSA cycle 1: Development of common PED SIM scenarios. PDSA cycle 2: Implementation of the SIMs in the PED using front line staff during regular shift times twice a week. Data on the quality of CPR will be collected from real-time observations performed during each SIM. PDSA cycle 3: Conduct paired anonymous surveys of the multidisciplinary resuscitation team to assess familiarity with PALS algorithms as well as qualitative assessment of communication dynamics and resuscitation team confidence. PDSA cycle 4: Assess the In Situ SIM Project’s impact on resuscitation team cognitive load, as measured by the well validated NASA Task Load Index. PDSA cycle 5: Process expansion to include more learners and staff specifically adding those working overnight shifts.
The data collected throughout the PDSA cycles will be summarized descriptively. Univariate analysis between pre and post sim initiation will be performed using chi squared analysis for categorical variables and T tests for continuous, parametric variables and Wilcoxon rank-sum testing for continuous, non-parametric variables. Continuous data will be reported as medians and interquartile ranges (IQR).
