Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role

Adam Cheng; Frank Overly; David Kessler; Vinay M Nadkarni; Yiqun Lin; Quynh Doan; Jonathan P Duff; Nancy M Tofil; Farhan Bhanji; Mark Adler; Alex Charnovich; Elizabeth A Hunt; Linda L Brown; International Network for Simulation-based Pediatric Innovation, Research, Education (INSPIRE) CPR Investigators

doi:10.1016/j.resuscitation.2014.11.015

Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role

Resuscitation. 2015 Feb:87:44-50. doi: 10.1016/j.resuscitation.2014.11.015. Epub 2014 Nov 26.

Authors

Collaborators

International Network for Simulation-based Pediatric Innovation, Research, Education (INSPIRE) CPR Investigators:
Jennifer Davidson, Dawn Taylor Peterson, MarjorieLee White, John Zhong, Vincent Grant, David Grant, Stephanie Sudikoff, Kimberly Marohn, Nicola Robertson, Ronald Gottesman, Hubert Wong, Aaron Donoghue, Robert M Sutton, Dana Niles, Jenny Chatfield, Nnenna Chime

Affiliations

¹ University of Calgary, KidSim-ASPIRE Research Program, Division of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada T3B 6A8. Electronic address: chenger@me.com.
² Hasbro Children's Hospital, Alpert Medical School of Brown University, 593 Eddy St, Providence, RI 02903, USA. Electronic address: foverly@lifespan.org.
³ Columbia University College of Physicians and Surgeons, 630 W 168th St, New York, NY 10032, USA. Electronic address: dk2592@cumc.columbia.edu.
⁴ The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: nadkarni@chop.edu.
⁵ KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, Canada T3B 6A8. Electronic address: jeffylin@hotmail.com.
⁶ British Columbia Children's Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4. Electronic address: qdoan@cw.bc.ca.
⁷ Stollery Children's Hospital, University of Alberta, 8215 112 St NW, Edmonton, AB, Canada T6G 2L9. Electronic address: jon.duff@albertahealthservices.ca.
⁸ Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave, S. Birmingham, AL 35233, USA. Electronic address: ntofil@peds.uab.edu.
⁹ Montreal Children's Hospital, McGill University, 2300 Tupper St, Montreal, QC, Canada H3H 1P3. Electronic address: farhan.bhanji@mcgill.ca.
¹⁰ Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University School of Medicine, 225 E Chicago Ave, Chicago, IL 60611, USA. Electronic address: m-adler@northwestern.edu.
¹¹ Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA. Electronic address: echarno1@jhmi.edu.
¹² Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA. Electronic address: ehunt@jhmi.edu.
¹³ Hasbro Children's Hospital, Alpert Medical School of Brown University, 593 Eddy St, Providence, RI 02903, USA. Electronic address: lbrown8@lifespan.org.

PMID: 25433294
DOI: 10.1016/j.resuscitation.2014.11.015

Abstract

Aim: Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions.

Methods: We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm.

Results: Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (p<0.001). Accurate estimation of CPR quality was poor for chest compression depth (0-13%), rate (5-46%) and chest compression fraction (60-63%). Perception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback.

Conclusion: Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training.

Keywords: Cardiopulmonary resuscitation; Chest compressions; Perception; Quality; Resuscitation.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cardiopulmonary Resuscitation* / education
Cardiopulmonary Resuscitation* / methods
Cardiopulmonary Resuscitation* / psychology
Feedback, Sensory
Female
Health Personnel* / psychology
Health Personnel* / standards
Heart Arrest / therapy*
Humans
Inservice Training / methods
Male
Outcome Assessment, Health Care
Professional Role
Quality Improvement
Simulation Training / methods*
Social Perception