Abstract 20603: Low Dose-High Frequency Psychomotor Cardiopulmonary Resuscitation Training in the Emergency Department Improves Simulated and Clinical Chest Compression Fraction

Background: High-quality cardiopulmonary resuscitation (CPR) is essential for functional survival from cardiac arrest. However, the opportunity to perform CPR is too infrequent to maintain proficiency for most providers. Low dose-high frequency psychomotor simulation has demonstrated maintenance of CPR proficiency among inpatient providers. We evaluated this type of CPR training via mobile simulation stations (Resuscitation Quality Improvement™ [RQI], American Heart Association, Dallas, TX) in an emergency department (ED) setting. Methods: Two RQI simulation stations were placed in an 85,000 visit ED of a university teaching hospital and quarterly training simulations integrated into normal nursing duties. We measured simulated and clinically delivered CPR quality metrics before and 1 year following implementation using RQI and ED defibrillators equipped with thoracic impedance (Lifepak 20e, Physio-control Inc., Redmond, WA). Descriptive statistics are presented as means with 95% confidence intervals. Results: We enrolled 150 nurses in June 2015. When compared to baseline data, use of RQI for 1 year was associated with improved simulated chest compression fraction (CCF; 94.6 [86.0-100] vs. 99.1 [98.2-100]; p-value=0.039) and percentage of compressions with adequate recoil (98.2% [96.5-100] vs. 99.2% [99.0-99.4]; p=0.028) and depth (87.3% [74.4-100] vs. 96.7% [97.8-95.6]; p=0.004). In addition, analysis of 4513s of clinically delivered CPR before and 4781s after 1 year of RQI implementation demonstrated an association with improved CCF (71.9 [54.5-89.3] vs. 85.9 [81.1-90.7]; p=0.031). Conclusions: Low dose- high frequency psychomotor simulation is associated with achievement and retention of high-quality CPR skills in an ED setting. Furthermore, its use is associated with improved clinical CCF.