Improving Pre-Arrest and Cardiac Arrest Performance in an Acute Care Setting

Background: Cardio-pulmonary resuscitation (CPR) and other emergent resuscitation practices in hospitals are lifesaving. Delayed or poor-quality CPR and resuscitation leads to increased mortality and poor neurologic function. Local Problem: Ogden Regional Medical Center (ORMC) has been identified as a hospital in need of improvement in nursing confidence, knowledge, and role responsibility during these emergent situations, in addition to decreasing anxiety. The increased nurse turnover caused by the COVID 19 pandemic resulted in less experienced nurses. The lack of experience throughout the hospital, specifically with CPR and resuscitation practices has been noticed and therefore, the identified the gap that this project aims to improve. Methods: A quality improvement project was developed to help increase nursing knowledge, confidence, and role responsibility, while decreasing anxiety. The nursing staff at ORMC was assessed to identify baseline self-perceptions and specific needs for education. A mock drill program was developed, after the initial survey, to address the specific needs of the nursing staff. These patient scenarios were all focused on different systems of the body and different tools and equipment that should be utilized. A post-implementation survey was sent to the nursing staff to determine the effectiveness of the mock drill program. Results: A total of 55 registered nurses (RNs) and 10 certified nursing assistants (CNAs) completed the mock drill interventions, with 27 RNs and 2 CNAs completing the pre- implementation survey, and 19 nurses and 2 CNAs completing the post-implimentation survey. The project found a statistically significant decrease in anxiety related to CPR and resuscitation after the implementation of the mock drill program (p=0.001). Non-statistically significant trends towards improvement in knowledge and preparedness was also found. Qualitative open-ended questions in the post-implementation survey revealed themes of increased knowledge and confidence. Conclusions: The mock drill program was a valuable resource to help decrease anxiety, and increase preparedness and knowledge in CPR, resuscitation, and other emergent situations. Replication of this quality improvement project is needed in other hospitals to determine if similar rates are feasible. This project has shown the benefit of mock programs in education of nurses with varying levels of experience and will be continued at ORMC.