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A NOVEL APPROACH FOR TRAINING RESUSCITATION TEAM LEADERS FOR IN-HOSPITAL CARDIAC ARRESTS: A GUIDE AND SIMULATION-BASED PROGRAM
Chest ; 162(4):A1473, 2022.
Article in English | EMBASE | ID: covidwho-2060826
ABSTRACT
SESSION TITLE Trainees Mental Well-Being and Performance SESSION TYPE Original Investigations PRESENTED ON 10/16/22 1030 am - 1130 am

PURPOSE:

Advanced Cardiovascular Life Support (ACLS) certification provides an essential foundation for the recognition and management of cardiac arrests. However, there remains a significant gap between ACLS certification and the competence and confidence required to effectively deploy gained skills to lead an ACLS team. Here we present preliminary data on a novel approach to bridge this gap in Internal Medicine second-year residents (PGY-2) at an academic center through the creation of an ACLS leadership guide and interdisciplinary manikin-based simulation program for in-hospital cardiac arrest (IHCA).

METHODS:

A pocket card guide for ACLS team leaders was created, focusing on providing a structured approach to leading any ACLS team. This guide included, but was not limited to, a mnemonic offering ordered steps to address during resuscitation as well as an approach for assessment and management of underlying causes of cardiac arrest (e.g. ‘Hs and Ts’), including ultrasound utilization. The simulation program, developed for training ACLS-certified PGY-2s, provides one-on-one learning for 2-4 residents per month with introduction and review of the aforementioned guide followed by cardiac arrest simulation with a resident leader, nurses, pharmacists, respiratory therapists, and medical assistants. Immediately after the simulation, there is a group followed by individual video-based feedback and debrief. Trainees are surveyed pre- and post-session on their perceptions of comfort and proficiency on variable components in leading resuscitation of IHCAs, using a 5-point Likert scale (1=strongly disagree;5=strongly agree). The program was launched on 07/15/21, but simulations were temporarily suspended during the peak Delta COVID-19 surge. The Mann-Whitney test was used for comparing pre- and post-session responses. Results are reported as frequencies and medians (interquartile range [IQR]).

RESULTS:

Seventeen PGY-2s have completed the training sessions to date, of which 17 and 14 have completed the pre- and post-session surveys, respectively. Compared to pre-session responses regarding leading a cardiac arrest team, there was marked post-session increase in feeling comfortable [generally] (3 [2-3] vs. 4 [4-5];p=<0.0001), feeling proficient (3 [2-3] vs. 4 [4-5];p=<0.0001), and feeling comfortable searching for the underlying cause of cardiac arrest (3 [2-3.25] vs. 4 [3-4];p=0.0359).

CONCLUSIONS:

These preliminary data show marked improvement in self-reported confidence and competence in leading a cardiac arrest team during IHCA among ACLS-certified Internal Medicine residents, following deployment of an ACLS leadership guide combined with a realistic, high-fidelity, and interdisciplinary, leadership-focused simulation program. CLINICAL IMPLICATIONS This novel program may enhance trainees’ leadership performance during IHCA, though its generalizability and impact on patients’ outcomes requires further study. DISCLOSURES No relevant relationships by Christopher Dayton No relevant relationships by Jenny Heins No relevant relationships by Lee Oud
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Chest Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Chest Year: 2022 Document Type: Article