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Published on: October 24, 2020
Improving role allocation for cardiopulmonary resuscitation (CPR) in the emergency department: a quality improvement
Sweta Giri1, Dawa Gyeltshen2, Neten Wangchuk2
1Emergency Department, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan swetagiri1992@gmail.com.
Insights
Improving cardiopulmonary resuscitation (CPR) team role clarity is crucial. A simple intervention increased CPR role delegation from 19% to 80%, enhancing emergency department teamwork and patient care.
Area of Science:
- Emergency Medicine
- Healthcare Quality Improvement
- Teamwork in Resuscitation
Background:
- Cardiopulmonary resuscitation (CPR) in emergency departments (EDs) is complex and chaotic.
- Optimal patient outcomes depend on effective teamwork and coordinated responses.
- A survey revealed only 19% of ED staff were familiar with their specific roles during CPR.
Purpose of the Study:
- To increase CPR role delegation from 19% to 80% within two months.
- To enhance interprofessional teamwork and accountability during resuscitation events.
Main Methods:
- Implemented a quality improvement project using four plan-do-study-act cycles.
- Introduced strategies including increased sensitization, simplified role assignment, and nursing team leader accountability.
- Utilized progress charts to motivate sustained adherence to project goals.
Main Results:
- Successfully increased the process indicator for CPR role delegation.
- Achieved and sustained the target of 80% role delegation for four consecutive weeks.
Conclusions:
- Demonstrates the effectiveness of simple, cost-effective interventions in improving CPR team dynamics.
- Highlights the importance of teamwork, accountability, and patience in achieving quality improvement goals.
- Suggests this model is replicable in other emergency departments.
Introduction:
In any healthcare setting, cardiopulmonary resuscitations (CPRs) stand out as demanding and chaotic resuscitation endeavours. Emergency departments (EDs) witness a significant volume of CPRs. Given the critical nature of CPR, content knowledge and procedural skills alone fall short in delivering optimal care. Effective teamwork, complemented by a well-coordinated response, is imperative for achieving favourable patient outcomes. A survey conducted in our ED highlighted that while the majority of staff acknowledged the significance of teamwork in CPR and were aware of the whiteboard for assigning team roles, only 19% were familiar with their individual roles during CPR.
Methods:
To address this gap, our project aimed to increasing the role delegation for CPR from 19% to 80% within 2 months. We formed an interprofessional team and implemented strategies through four plan-do-study-act cycles. Interventions encompassed increasing sensitisation, creating a simplified format for assigning team roles and entrusting the nursing team leader of each shift with the responsibility of role assignment for accountability. The sharing of progress charts for acknowledgment served as a motivating factor, leading to sustained adherence to the project goals without necessitating reminders in the final two weeks.
Results:
This project proved to be highly successful as our process indicator steadily increased and remained above the target for 4 consecutive weeks.
Conclusion:
Our results underscore the importance of patience and teamwork in achieving project objectives. It serves as a good example of the efficiency of simple and cost-effective interventions, one that can be replicated and implemented in other EDs.
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