Association of CPR simulation program characteristics with simulated and actual performance during paediatric in-hospital cardiac arrest

Katherine Cashen; Robert M Sutton; Ron W Reeder; Tageldin Ahmed; Michael J Bell; Robert A Berg; Robert Bishop; Matthew Bochkoris; Candice Burns; Joseph A Carcillo; Todd C Carpenter; J Wesley Diddle; Myke Federman; Ericka L Fink; Deborah Franzon; Aisha H Frazier; Stuart H Friess; Kathryn Graham; Mark Hall; David A Hehir; Christopher M Horvat; Leanna L Huard; Tensing Maa; Arushi Manga; Patrick S McQuillen; Ryan W Morgan; Peter M Mourani; Vinay M Nadkarni; Maryam Y Naim; Daniel Notterman; Chella A Palmer; Murray M Pollack; Anil Sapru; Carleen Schneiter; Matthew P Sharron; Neeraj Srivastava; Shirley Viteri; Heather A Wolfe; Andrew R Yates; Athena F Zuppa; Kathleen L Meert; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatrics Critical Care Research Network (CPCCRN); National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators

doi:10.1016/j.resuscitation.2023.109939

Association of CPR simulation program characteristics with simulated and actual performance during paediatric in-hospital cardiac arrest

Resuscitation. 2023 Oct:191:109939. doi: 10.1016/j.resuscitation.2023.109939. Epub 2023 Aug 23.

Authors

Katherine Cashen¹, Robert M Sutton², Ron W Reeder³, Tageldin Ahmed⁴, Michael J Bell⁵, Robert A Berg², Robert Bishop⁶, Matthew Bochkoris⁷, Candice Burns⁸, Joseph A Carcillo⁷, Todd C Carpenter⁶, J Wesley Diddle⁵, Myke Federman⁹, Ericka L Fink⁷, Deborah Franzon¹⁰, Aisha H Frazier¹¹, Stuart H Friess¹², Kathryn Graham², Mark Hall¹³, David A Hehir², Christopher M Horvat⁷, Leanna L Huard⁹, Tensing Maa¹³, Arushi Manga¹², Patrick S McQuillen¹⁰, Ryan W Morgan², Peter M Mourani¹⁴, Vinay M Nadkarni², Maryam Y Naim², Daniel Notterman¹⁵, Chella A Palmer³, Murray M Pollack⁵, Anil Sapru⁹, Carleen Schneiter⁶, Matthew P Sharron⁵, Neeraj Srivastava⁹, Shirley Viteri¹¹, Heather A Wolfe², Andrew R Yates¹³, Athena F Zuppa², Kathleen L Meert¹⁶; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatrics Critical Care Research Network (CPCCRN); National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators

Affiliations

¹ Department of Pediatrics, Duke Children's Hospital, Duke University, 2301 Erwin Road, Durham, NC 27710, USA.
² Department of Anaesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 34th Street and Civic Centre Blvd, Philadelphia, PA 19104, USA.
³ Department of Pediatrics, University of Utah, 295 Chipeta Way, P.O. Box 581289, Salt Lake City, UT 84158, USA.
⁴ Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, 3901 Beaubien Blvd, Detroit, MI 48201, USA.
⁵ Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, 111 Michigan Ave, NW, Washington, DC 20010, USA.
⁶ Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, 13121 East 17th Ave, Aurora, CO 80045, USA.
⁷ Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, One Children's Hospital Drive, 4401 Penn Ave, Pittsburgh, PA 15224, USA.
⁸ Department of Pediatrics and Human Development, Michigan State University, 100 Michigan St, NE, Grand Rapids, MI 49503, USA.
⁹ Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA.
¹⁰ Department of Pediatrics, Benioff Children's Hospital, University of California-San Francisco, 1845 Fourth Street, San Francisco, CA 94158, USA.
¹¹ Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803, USA; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA.
¹² Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, One Children's Place, St. Louis, MO 63110, USA.
¹³ Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA.
¹⁴ Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR 72202, USA.
¹⁵ Department of Molecular Biology, Princeton University, 119 Lewis Thomas Laboratory, Washington Road, Princeton, NJ 08544, USA.
¹⁶ Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, 3901 Beaubien Blvd, Detroit, MI 48201, USA. Electronic address: kmeert@dmc.org.

PMID: 37625580
PMCID: PMC10528057
DOI: 10.1016/j.resuscitation.2023.109939

Abstract

Aim: To evaluate associations between characteristics of simulated point-of-care cardiopulmonary resuscitation (CPR) training with simulated and actual intensive care unit (ICU) CPR performance, and with outcomes of children after in-hospital cardiac arrest.

Methods: This is a pre-specified secondary analysis of the ICU-RESUScitation Project; a prospective, multicentre cluster randomized interventional trial conducted in 18 ICUs from October 2016-March 2021. Point-of-care bedside simulations with real-time feedback to allow multidisciplinary ICU staff to practice CPR on a portable manikin were performed and quality metrics (rate, depth, release velocity, chest compression fraction) were recorded. Actual CPR performance was recorded for children 37 weeks post-conceptual age to 18 years who received chest compressions of any duration, and included intra-arrest haemodynamics and CPR mechanics. Outcomes included survival to hospital discharge with favourable neurologic status.

Results: Overall, 18,912 point-of-care simulations were included. Simulation characteristics associated with both simulation and actual performance included site, participant discipline, and timing of simulation training. Simulation characteristics were not associated with survival with favourable neurologic outcome. However, participants in the top 3 sites for improvement in survival with favourable neurologic outcome were more likely to have participated in a simulation in the past month, on a weekday day, to be nurses, and to achieve targeted depth of compression and chest compression fraction goals during simulations than the bottom 3 sites.

Conclusions: Point-of-care simulation characteristics were associated with both simulated and actual CPR performance. More recent simulation, increased nursing participation, and simulation training during daytime hours may improve CPR performance.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Child; Infant; Neonate; Simulation.

Publication types

Randomized Controlled Trial
Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

Cardiopulmonary Resuscitation* / education
Child
Clinical Competence
Heart Arrest* / therapy
Hospitals, Pediatric
Humans
Prospective Studies

Abstract

Publication types

MeSH terms

Grants and funding