Resuscitation Perspectives Series: Top Takeaways

In our Resuscitation Perspectives interview series, we’ve heard from responders and staff across all types of resuscitation roles: nurses, paramedics, materials management, and more. Our interviewees have weighed in on a variety of resuscitation topics, ranging from their personal career path and roles to their thoughts on where resuscitation care is headed in the future.

Below, we’ve rounded up some common themes across many of our conversations. Keep reading as we share top insights from our interviewees on each topic, our main takeaways, and actionable tips that hospitals can implement now.

Emergency inventory management

What our interviewees had to say

As we learned in our conversation with an assistant vice president of supply operations, having “the right things in the right place at the right time” is never more important than in a high-stakes emergency like a Code Blue. His real-life observations are backed up by studies that show that common crash cart issues can adversely impact patient safety.¹  A Labor & Delivery nurse we interviewed spoke to these concerns as well, noting how easy it is to accidentally grab the wrong item from a crash cart during an emergency.

our top takeaway

Crash cart organization matters, and it starts with the staff members who stock the carts.

action steps

• Encourage communication between clinicians and materials management. Supply chain staff who stock the carts may not have clinical experience, so it’s crucial that they gain a basic understanding of the supplies and how they’re used in a code. Our supply chain interviewee’s advice to his staff? “If you don’t know, go find the person who uses this item and ask them.” On the flip side, clinicians should understand the importance of these questions and be willing to offer their expertise.
• Have materials management staff attend mock codes to better understand the pace, stakes, and importance of crash cart organization during a code.
•  Automate error-prone crash cart tasks. Read our article on reducing risk with crash cart automation and how solutions like the EMMIT® Emergency Care System by Nuvara® can help.

Mastering the basics

what our interviewees had to say

One of the most thought-provoking conversations came from a resuscitation consultant who regularly advises hospitals to simplify and focus on the basics. While technology and advances in care certainly have their place in improving cardiac arrest outcomes (more on that in the next section), this interviewee championed a back-to-the-basics mentality: “If you’re not capable of reasonable-quality CPR…then don’t focus on a more invasive and complex procedure. Get the basics right.”

our top takeaway

According to The Joint Commission, crash cart disorganization is one of the top clinical problems found by surveyors. And high-quality CPR is one of the few interventions that has been consistently linked to improved cardiac arrest outcomes.² Our point? If your hospital hasn’t yet mastered these basics, start there first.

action steps

• Emphasize strong CPR response at your hospital, including commonly overlooked aspects like chest recoil.
• Use real-time CPR feedback, like end-tidal carbon dioxide readings, to help keep clinicians on track during codes.
• Implement the tips from the previous section on improving crash cart stocking processes.

Technology

What our interviewees had to say

Not surprisingly, technology was a popular topic in our conversations. Interviewees shared trends that they were excited about — like the increasing use of mechanical cardiopulmonary resuscitation (mCPR) — as well as areas in which innovation is sorely needed. “I think we lag significantly in the utilization of technology in resuscitation compared to the technologies that we use on a day-to-day basis,” a critical care director told us. “Technology to help individual practitioners perform at their best is the way of the future.”

our top takeaway

We heard about everything from advances in trauma care to extracorporeal cardiopulmonary resuscitation to wearable sensors that can detect cardiac arrest. But the two most talked-about tools were mCPR and electronic documentation.

action steps

• Upgrade to electronic documentation: “There is so much chaos, confusion, and scrambling during a code….as a documenter, you might not hear everything or you might miss documenting something that happened,” one of the nurses we interviewed observed. Outdated paper-based documentation approaches don’t help. Our advice: Start by reading up on the benefits of switching from paper to electronic documentation, then learn how solutions like Nuvara’s CoDirector® Resuscitation Software can help.
• Incorporate mCPR: With benefits like high-quality CPR and reduced stress for responders, it’s not surprising that mCPR was frequently mentioned as a gamechanger for both in-hospital and out-of-hospital cardiac arrest. “We don’t have any randomized controlled trials to show it, but our patients have been getting better overall care because the medics have an extra set of hands,” a paramedic told us. Mechanical CPR comes with risks too, so if your hospital is planning to introduce it, learn about our strategies for a smooth rollout.

Teamwork

What our interviewees had to say

Whether it was a discussion of how to help new nurses adjust to real-life codes or the importance of a shared mental model during codes, teamwork was a central theme in many of our conversations. As the resuscitation consultant we spoke to noted, “Everything in resuscitation is team based…alone you are nothing — or at least not effective!”

Our top takeaway

The coordinated response of the team matters as much, if not more than, the actions of any individual. As one of our interviewees put it: “I don’t think one single individual impacts survival in a cardiac arrest. Cardiac arrests are scenarios that require coordination, and coordination involves many players.”

Action steps

• Bring new nurses into the fold. More experienced staff members can help new nurses acclimate to real-life events by proactively sharing their knowledge and modeling calm during codes.
• Use realistic training scenarios. While both high- and low-fidelity mock codes offer unique benefits, a critical care director we spoke to emphasized the importance of realistic training scenarios to prepare teams optimally for emergency events.