Abstract 19983: Major Differences in Advanced Life Support Training Strategies Among Danish Hospitals - A Nationwide Study

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Abstract

Introduction: Advanced life support (ALS) training may increase survival from in-hospital cardiac arrest. Efficient ALS training includes practice of both technical and non-technical skills in a realistic setting with frequent retraining to avoid decay in ALS skills. ALS training strategies among hospitals are currently unknown. This study aimed to investigate ALS training strategies in Danish hospitals.

Methods: We included all public, somatic hospitals in Denmark with a cardiac arrest team (n=46). Online questionnaires were distributed to resuscitation officers in each hospital. Questionnaires inquired information on: A) Course duration and retraining interval, B) Training methods and setting, C) Scenario training and practicing non-technical skills.

Results: In total, 44 hospitals replied (response rate: 96%). ALS training was conducted in 43 hospitals (98%). Median (range) ALS course duration was 3.5 (1-8) hours. Retraining was conducted every year (28%), every second year (49%), less frequent (19%) and 4% retrained with different intervals depending on healthcare profession. E-learning was as a part of ALS training by 21%. Overall, 28% conducted ALS training in a meeting room or auditorium while 72% conducted ALS training in a simulation unit or clinical setting. Chest compressions were trained on a bed by 63%, on a stretcher or table by 27%, and no hospitals used a backboard for training. Median (range) time spent on team training was 2.0 (0.5-5) hours. Overall, 51% conducted ALS training for all cardiac arrest team members (i.e. nurses, physicians, and orderlies) and 18% performed in-situ simulated cardiac arrests in addition to regular ALS training. Termination of resuscitation was practiced in team training by 60% of hospitals. Closed-loop communication was used by all (100%), but only 56% evaluated non-technical skills during or after team training. Overall, 2% reported to practice specific team leadership skills.

Conclusion: There are major differences in duration, retraining interval, and methods for ALS training in Danish hospitals. These differences call for research to support standardized hospital ALS teaching strategies that improve survival.

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