Improving cardiopulmonary resuscitation quality and resuscitation training by combining audiovisual feedback and debriefing

C Jessica Dine, Ronna E Gersh, Marion Leary, Barbara J Riegel, Lisa M Bellini, Benjamin S Abella
Critical Care Medicine 2008, 36 (10): 2817-22

OBJECTIVE: Delivery of high-quality cardiopulmonary resuscitation increases survival from cardiac arrest, yet studies have shown that cardiopulmonary resuscitation quality is often poor during actual in-hospital resuscitation. Furthermore, recent work has shown that audiovisual feedback alone during cardiopulmonary resuscitation modestly improves performance. We hypothesized that a multimodal training method comprising audiovisual feedback and immediate debriefing would improve cardiopulmonary resuscitation performance among care providers.

DESIGN: Prospective randomized interventional study.

SETTING: Simulated cardiac arrests at an academic medical center.

SUBJECTS: A total of 80 nurses were randomized to two groups.

INTERVENTION: Each group underwent three trials of simulated cardiac arrest. The "feedback" group received real-time audiovisual feedback during the second and third trials, whereas the "debriefing-only" group performed cardiopulmonary resuscitation without feedback. Both groups received short individual debriefing after the second trial.

MEASUREMENTS: Cardiopulmonary resuscitation quality was recorded using a cardiopulmonary resuscitation-sensing defibrillator that measures chest compression rate/depth and can deliver audiovisual feedback messages from both groups during the three trials. An adequate compression rate was defined as 90-110 compressions/min and an adequate depth as 38-51 mm.

MAIN RESULTS: In the debriefing-only group, the percentage of participants providing compressions of adequate depth increased after debriefing, from 38% to 68% (p = 0.015). In the feedback group, depth compliance improved from 19% to 58% (p = 0.002). Compression rate did not improve significantly with either intervention alone. The combination of feedback and debriefing improved compression rate compliance from 45% to 84% (p = 0.001) and resulted in a doubling of participants providing compressions of both adequate rate and depth, 29% vs. 64% (p = 0.005).

CONCLUSIONS: Significant cardiopulmonary resuscitation quality deficits exist among healthcare providers. Debriefing or feedback alone improved cardiopulmonary resuscitation quality, but the combination led to marked performance improvements. Cardiopulmonary resuscitation feedback and debriefing may serve as a powerful tool to improve rescuer training and care for cardiac arrest patients.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"