A Cardiac Arrest Quality Improvement Initiative Utilizing Get with the Guidelines - Resuscitation Registry and Post-Arrest Debriefing

Despite decades of utilization and multiple technological advances, outcomes from cardiopulmonary resuscitation (CPR) remain poor, with only approximately 20% of adults surviving to discharge. Survival from cardiac arrest is directly associated with the quality of CPR delivered. The American Heart Association (AHA) and Institute of Medicine (IOM) recommend continuous quality improvement initiatives to monitor and improve the quality of CPR and cardiac arrest outcomes.
Project Purpose: The overall purpose of this project was to describe and evaluate the implementation of a continuous quality improvement project targeting cardiac arrest outcomes utilizing the AHA Get With The Guidelines-Resuscitation (GWTG-R) registry with post-arrest debriefing.
Method: A Plan-Do-Check-Act quality improvement method was utilized to collect and analyze baseline cardiac arrest data for the project year on select cardiac nursing units at an academic medical center in the Southeastern United States. An interprofessional cold post-arrest debriefing was held for any cardiac arrest that occurred during a 3 month project period. Cardiac arrest data was abstracted from patient electronic medical records. Evaluation of the cold post-arrest debriefing intervention was completed via staff survey.
Results and Discussion: Utilization of the AHA GWTG-R registry organized the cardiac arrest data collected. Analysis showed several missed opportunities to receive GWTG-R “recognition measures” for achieving guideline benchmarks during the project year. The analysis also revealed trends in the incidence of cardiac arrest at specific time periods that could potentially become the target of future interventions. The post-arrest debriefing survey revealed that the majority of staff regarded the intervention as very or extremely beneficial for influencing their personal behaviors, teaching them something new, and learning about medical center comparison data. The survey also indicated that staff were likely to recommend the debriefing to others. The organization and trending of cardiac arrest data using GWTG-R and the high acceptability of post-arrest debriefing shows promise for continued use of these interventions as continuous quality improvement initiatives for improvement of cardiac arrest outcomes.