Posted by Texas Children's Hospital Services › Nursing › Our Stories on May 3rd 2021

Nursing launches system wide initiative, takes CPR training to the next level

Nursing launches system wide initiative, takes CPR training to the next level

Sudden cardiac arrest can happen to anyone, anywhere, any time – and it often happens with little to no warning. More than 200,000 cardiac arrests occur in hospitals each year in the United States. To keep employees better prepared to perform cardiopulmonary resuscitation (CPR) and contribute to improved patient outcomes, Texas Children’s recently launched a new Nursing initiative that takes CPR training to the next level.

“We don’t have to perform CPR too often, but unfortunately, when we have to provide this life-saving procedure, we have to do it well,” said Nursing Professional Development Specialist Gayle Young. “Through this initiative, resuscitation skills are accessed and reinforced to give staff the added confidence they need to achieve and maintain high quality CPR performance in the event of a cardiac emergency.”

Resuscitation Quality Improvement, (RQI), the American Heart Association’s gold standard for Basic Life Support (BLS) training, is a quarterly training program at Texas Children’s that offers real-time visual and audio feedback on compressions and ventilations to support the mastery of high quality CPR skills. Unlike conventional CPR classes – where an instructor provides his or her own personal feedback – RQI uses computer-based eSimulation technology that evaluates performance quality and solicits objective feedback in the form of positive reinforcement or suggestions for improvement.

“Being able to see the actual outcome of our compressions is amazing,” said Cardiac ICU Education Coordinator Shannon Cummings. “You can see if you’re under or over inflating, if you’re going too deep or too shallow, or if you’re not allowing for recoil and letting the chest expand. The program walks you through the steps, and tells you when to adjust your compressions, so you can perform CPR effectively.”

This program, administered by Texas Children’s Nursing Professional Development (NPD) Team, consists of online learning modules and skills assessments that are completed quarterly instead of once every two years. As part of this quarterly training, on-campus simulation stations will be equipped with adult and infant manikins, and a computer that connects to the CPR training materials.

After successfully completing the RQI training curriculum, staff are issued an RQI e-Credential card that must be renewed quarterly and a BLS e-Card that is renewable every two years. Additionally, staff can keep track of their completion and expiration via HealthStream.

“Studies have shown that CPR skills can decay within three to six months after initial hands-on training,” said Nursing Professional Development Assistant Director Dr. Angie Rangel. “The only way to master basic life-saving skills is through regular, measured and frequent practice. Through quarterly drills, we’re reinforcing the confidence and competence staff need to perform high quality CPR. At the end of the day, it’s all about improving outcomes. And with RQI, we are really moving towards great patient outcomes.”

Several nurses and direct patient care providers, as well as Child Life staff, participated in the soft launch of the RQI program on February 4, and these participants already see the benefits this program offers.

“In Child Life, a lot of times we’re doing one-on-one activities where there’s no medical staff around our patients in the room,” said Child Life Specialist Danielle Coleman. “So just in case something unexpected happens with a code, we can be the first responders and help that child out and be there for support.”

“I think this program is great, and will help refresh our skills more frequently than once every two years,” said Pavilion for Women Ambulatory Education Coordinator Leslie Williams. “We’ll be more comfortable with performing the resuscitation skills and it’s just better for the patients and the families.”

The NPD team has already identified 75 “super users” from Texas Children’s Medical Center Campus, Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands, and several Specialty Care Centers to be early adopters of RQI before the program is rolled out in phases across the system.