Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines
Background: In-situ simulations are effective in identifying latent safety threats. In high-volume elective operating departments, cardiac arrests are rare due to strict patient selection. Implementing in-situ cardiac arrest simulations in these settings is crucial to evaluate adherence to cardiopul...
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Elsevier
2025-03-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000244 |
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| author | Anna Sundelin Anders Stålman Therese Djärv |
| author_facet | Anna Sundelin Anders Stålman Therese Djärv |
| author_sort | Anna Sundelin |
| collection | DOAJ |
| description | Background: In-situ simulations are effective in identifying latent safety threats. In high-volume elective operating departments, cardiac arrests are rare due to strict patient selection. Implementing in-situ cardiac arrest simulations in these settings is crucial to evaluate adherence to cardiopulmonary resuscitation (CPR) guidelines and enhance patient safety by detecting and managing safety threats. Method: From October 2023 to June 2024, a 20-minute in-situ cardiac arrest simulation with debriefing was conducted bi-weekly in a high-volume orthopedic surgery ward with seven operating rooms, without additional staffing. Latent safety threats were identified and addressed. Time to call for help, start of compressions, and first defibrillation was measured, as was airway management choice by anesthesia. Staff confidence was assessed via an anonymous 11-step Likert-scale questionnaire before and after the project, ranging from 0 (no confidence) to 10 (highest confidence). Results: 22 simulations were conducted. Multiple safety improvements were implemented, including role clarification and development of an amiodarone kit. Adherence to cardiopulmonary resuscitation guidelines was strong, achieving time goals in 21 simulations (95%). Anesthesia intubated in 100% of cases when present (16/22, 73%). The questionnaire response rate was 72% (38/53). Staff confidence significantly improved after the project, with median scores increasing from 4.5 to 7.0 (IQR 2.25–7 before, 6–8 after) for personal ability (p < 0.001) and 6.5 to 8.5 (IQR 4–7.25 before, 8–9 after) for team ability (p < 0.001). Conclusions: A 20-minute in-situ cardiac arrest simulation with debriefing is feasible in a high-volume operating department. Mitigating safety threats and achieving guideline adherence demonstrates functional emergency routines. Staff confidence in managing cardiac arrests significantly increased. |
| format | Article |
| id | doaj-art-9c7cb752e04c4bd8b64634597175de6a |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-9c7cb752e04c4bd8b64634597175de6a2025-02-06T05:12:52ZengElsevierResuscitation Plus2666-52042025-03-0122100887Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routinesAnna Sundelin0Anders Stålman1Therese Djärv2Capio Artro Clinic Operation Department Sophiahemmet Stockholm Sweden; Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care, Karolinska Institutet Stockholm Sweden; Corresponding author at: Department of Physiology and Pharmacology, Section of Anesthesia and Intensive Care, Solnavägen 9, SE-171 65 Solna Sweden.Capio Artro Clinic Operation Department Sophiahemmet Stockholm Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet Stockholm SwedenDepartment of Medicine Solna, Karolinska Institutet Stockholm Sweden; Emergency Department, Karolinska University Hospital Stockholm SwedenBackground: In-situ simulations are effective in identifying latent safety threats. In high-volume elective operating departments, cardiac arrests are rare due to strict patient selection. Implementing in-situ cardiac arrest simulations in these settings is crucial to evaluate adherence to cardiopulmonary resuscitation (CPR) guidelines and enhance patient safety by detecting and managing safety threats. Method: From October 2023 to June 2024, a 20-minute in-situ cardiac arrest simulation with debriefing was conducted bi-weekly in a high-volume orthopedic surgery ward with seven operating rooms, without additional staffing. Latent safety threats were identified and addressed. Time to call for help, start of compressions, and first defibrillation was measured, as was airway management choice by anesthesia. Staff confidence was assessed via an anonymous 11-step Likert-scale questionnaire before and after the project, ranging from 0 (no confidence) to 10 (highest confidence). Results: 22 simulations were conducted. Multiple safety improvements were implemented, including role clarification and development of an amiodarone kit. Adherence to cardiopulmonary resuscitation guidelines was strong, achieving time goals in 21 simulations (95%). Anesthesia intubated in 100% of cases when present (16/22, 73%). The questionnaire response rate was 72% (38/53). Staff confidence significantly improved after the project, with median scores increasing from 4.5 to 7.0 (IQR 2.25–7 before, 6–8 after) for personal ability (p < 0.001) and 6.5 to 8.5 (IQR 4–7.25 before, 8–9 after) for team ability (p < 0.001). Conclusions: A 20-minute in-situ cardiac arrest simulation with debriefing is feasible in a high-volume operating department. Mitigating safety threats and achieving guideline adherence demonstrates functional emergency routines. Staff confidence in managing cardiac arrests significantly increased.http://www.sciencedirect.com/science/article/pii/S2666520425000244Cardiac arrestCardiopulmonary resuscitation CPRPost-resuscitation careRapid response systemsResuscitation simulationResuscitation training |
| spellingShingle | Anna Sundelin Anders Stålman Therese Djärv Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines Resuscitation Plus Cardiac arrest Cardiopulmonary resuscitation CPR Post-resuscitation care Rapid response systems Resuscitation simulation Resuscitation training |
| title | Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines |
| title_full | Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines |
| title_fullStr | Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines |
| title_full_unstemmed | Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines |
| title_short | Effectiveness of ultra-rapid (20 min) high-frequency in-situ cardiac arrest simulations in a high-volume operating department – A tool for evaluating and implementing emergency routines |
| title_sort | effectiveness of ultra rapid 20 min high frequency in situ cardiac arrest simulations in a high volume operating department a tool for evaluating and implementing emergency routines |
| topic | Cardiac arrest Cardiopulmonary resuscitation CPR Post-resuscitation care Rapid response systems Resuscitation simulation Resuscitation training |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000244 |
| work_keys_str_mv | AT annasundelin effectivenessofultrarapid20minhighfrequencyinsitucardiacarrestsimulationsinahighvolumeoperatingdepartmentatoolforevaluatingandimplementingemergencyroutines AT andersstalman effectivenessofultrarapid20minhighfrequencyinsitucardiacarrestsimulationsinahighvolumeoperatingdepartmentatoolforevaluatingandimplementingemergencyroutines AT theresedjarv effectivenessofultrarapid20minhighfrequencyinsitucardiacarrestsimulationsinahighvolumeoperatingdepartmentatoolforevaluatingandimplementingemergencyroutines |