Bedside chest compression skills: Performance and skills retention in in-hospital trained pediatric providers. A simulation study


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Abstract

Purpose:To assess the effects of a real-time feedback device and refresher sessions in acquiring and retaining chest compression skills.Methods:Healthcare providers participated in refresher sessions at 3-time points (blocks) over 1-year. At each block, chest compression (CC) skills were assessed on an infant and adult task trainer, in one 2-min trial without feedback (blinded), and up to three 2-min trials with feedback (unblinded). Skills retention over time was explored at three time lags: 1–3, 3–6, >6months. Data collected included chest compression rate (100–120/min), depth (4cm for infants and 5cm for adults), and recoil between compressions.Results:Among 194 participants, achievement of excellent CC (≥90% of adequate compressions for all parameters) increased with feedback. Linear mixed models found significant (p<0.05) improvement in rate, depth, and recoil. Performance between last unblinded trial in block 1 with the following blinded trial in block 2 significantly decayed in rate on both task trainers irrespective of time passed, while depth and recoil performance were maintained only for infants.Conclusions:A real-time visual feedback device improved CC skills with better results in infants. Skills decayed over time despite two refresher sessions with feedback.HIGHLIGHTSOutcomes from cardiac arrest greatly depend on the quality of resuscitation provided.Healthcare providers struggle to provide high-quality cardiopulmonary resuscitation.Using feedback devices greatly improves the quality of cardiopulmonary resuscitation.The quality of resuscitation skills decay over time.Two refresher sessions improve resuscitation skills but not retention of skills.

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