دورية أكاديمية
Establishing a Quality Improvement Program for Pediatric In-hospital Cardiac Arrest.
| العنوان: | Establishing a Quality Improvement Program for Pediatric In-hospital Cardiac Arrest. |
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| المؤلفون: | Freedman AJ; From the Department of Pediatrics, Division of Critical Care, Saint Louis University, St. Louis, Missouri., Madsen EC; From the Department of Pediatrics, Division of Critical Care, Saint Louis University, St. Louis, Missouri., Lowrie L; From the Department of Pediatrics, Division of Critical Care, Saint Louis University, St. Louis, Missouri. |
| المصدر: | Pediatric quality & safety [Pediatr Qual Saf] 2023 Dec 12; Vol. 8 (6), pp. e706. Date of Electronic Publication: 2023 Dec 12 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101702480 Publication Model: eCollection Cited Medium: Internet ISSN: 2472-0054 (Electronic) Linking ISSN: 24720054 NLM ISO Abbreviation: Pediatr Qual Saf Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Philadelphia, PA] : Wolters Kluwer Health, Inc., [2016]- |
| مستخلص: | Background: Pediatric In-hospital Cardiac Arrest (IHCA) is a rare event with a 50-55% mortality rate. Techniques of Cardiopulmonary Resuscitation (CPR), medication and electrical therapy timing, team dynamics, simulation and debriefing programs are associated with improved outcomes. This study aimed to improve outcomes after IHCA by describing and implementing quality improvement processes that cross and coordinate among traditional siloed pediatric resuscitation team structures. Methods: We chose three outcome measures: (1) return of spontaneous circulation (ROSC), (2) 24-hour survival after IHCA, and (3) survival to hospital discharge. Process outcomes include (1) hot debriefs performed with a standardized form, (2) code documentation using a revised form, and (3) formal code team review presented to a central Emergency Management Committee, using a standardized form. Results: One hundred and thirty-two patients experienced 176 events during the 36-month study period. Survival to hospital discharge increased from 33% during year 1 to 60% during year 2 ( P < 0.05) but decreased to 45% in year 3. Both hot debrief performance and code documentation process methods did not demonstrate widespread adoption, but formal code team review was documented in 80% of events quite rapidly. Conclusions: There are common traits inherent to effective CPR team response. Ensuring optimal performance of these common tasks and techniques in every pediatric IHCA event in our hospital is being addressed by committee reorganization, task simplification, new technology acquisition and enhanced feedback loops. Early outcome analysis shows initial improvement in survival to hospital discharge after pediatric IHCA. (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.) |
| تواريخ الأحداث: | Date Created: 20231213 Latest Revision: 20231213 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10715786 |
| DOI: | 10.1097/pq9.0000000000000706 |
| PMID: | 38089827 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2472-0054 |
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| DOI: | 10.1097/pq9.0000000000000706 |