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A Better Way to Keep CPR Skills Sharp

Posted on Oct 23, 2018

Clinicians are required to complete RQI (Resuscitation Quality Improvement) CPR training every three months.
Clinicians at Johns Hopkins All Children's are required to complete RQI (Resuscitation Quality Improvement) CPR training every three months. Research shows the RQI approach improves CPR performance, which can help save lives.

“Compress a little deeper. Be sure compressions are in the middle of the chest. Compressions should be faster … that’s right!”

The voice of an advanced simulation system paired with onscreen graphics guides the hands of Kimberly Suarez, R.N., a clinical team leader with the nephrology and dialysis program at Johns Hopkins All Children’s Hospital. As she performs CPR on a high-tech mannequin, which responds just as an actual patient would, she adjusts her technique in response to the verbal and visual cues, and soon achieves a 100 percent score.

Suarez was completing her first CPR recertification module at a special event in the new Johns Hopkins All Children’s Research and Education Building. The building’s Center for Medical Simulation and Innovative Education, the largest pediatric simulation center in the state, hosted the event to roll out a new type of CPR training, illustrating the impact of simulation in improving clinical care.

The hospital has adopted the American Heart Association’s RQI (Resuscitation Quality Improvement) CPR training for renewing certification in basic and advanced pediatric life support. Johns Hopkins All Children’s is the first freestanding children’s hospital in the southeast and among the first in the country to adopt this innovative system that helps clinicians practice and maintain optimal CPR skills. Instead of attending a single day of training every two years, nurses, respiratory therapists and physicians will complete brief simulation sessions every three months that provide real-time feedback.

Are the chest compressions deep enough and applied at the right spot? Are the ventilations too shallow? And, what about the compression fraction, which measures the percentage of total CPR time that the patient actually receives chest compressions? RQI provides feedback on it all.

“This was a great experience,” Suarez says of her first RQI assignment. “Thankfully I don’t have a lot of opportunity to do real-life CPR in our dialysis unit, so getting actual hands-on training was fantastic. It will help with maintaining these skills, as opposed to a class once every two years. And the feedback was great.”

“We know that high-quality CPR saves lives,” says Jennifer Arnold, M.D., medical director of simulation at Johns Hopkins All Children’s Hospital. “Research shows the RQI approach of more frequent training, realistic scenarios and immediate feedback can improve mastery learning, which improves CPR performance. RQI gives us an opportunity to save more lives.”

The skills sessions are reinforced by a separate online curriculum that requires several additional hours over the course of two years.

Most of the RQI stations (carts) being used to launch RQI will be located in the hospital’s inpatient units, with one always available in the simulation center. Clinicians receive an email reminder that their next simulation is due. They will visit an RQI cart every three months, log in, watch a short video highlighting the skills to be practiced and measured, and then complete the 10-minute skills session.

And one day, those 10 minutes just might make a world of difference to a child and family.

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