From Door to Recovery: A Collaborative Approach to the Development of a Post Cardiac Arrest Center

2.50
Hdl Handle:
http://hdl.handle.net/10755/306557
Category:
Abstract
Type:
Poster
Title:
From Door to Recovery: A Collaborative Approach to the Development of a Post Cardiac Arrest Center
Author(s):
Calder, Shelley; Williams, Donna
Lead Author STTI Affiliation:
Non-member
Author Details:
Shelley Calder, MSN, RN, CEN, scalder@bidmc.harvard.edu; Donna Williams, MS, BSN, RN, CCRN
Abstract:

Evidence-based Practice Abstract

Purpose: Each year 325,000 Americans experience pre hospital cardiac arrest. Centers treating a higher volume of post cardiac arrest patients, in addition to having comprehensive treatment guidelines, demonstrate decreased mortality and improved patient outcomes. The purpose of this quality improvement project was to improve post cardiac care using a multi-disciplinary, collaborative approach. Critical care and emergency medicine physicians and nurse leaders developed and implemented clinical guidelines, staff and patient education, and ultimately a cardiac arrest center.

Design: This prospective QI project started in 2006 and is ongoing. The mission, guiding the development of a Cardiac Arrest Center was: to provide excellence in the clinical care of post cardiac arrest patients, provide education for the management of the post cardiac arrest patient, and perform quality research related to all aspects of post cardiac arrest syndrome.

Setting: A Level I, university-affiliated, teaching hospital with 420 licensed beds, includes: 54 emergency care beds and a total of 62 critical care beds.

Participants /Subjects: A multidisciplinary team consisting of physicians, clinical nurse specialists, front line staff and research assistants from critical care, emergency department and cardiology.

Methods: Interventions included: Identification of key stakeholders, provision of education on post resuscitation care based on professional guidelines/recommendations, selection of safe standardized equipment for cooling and temperature management, development of guidelines/policies for post cardiac arrest management supported by documentation tools and order sets, designation of post cardiac arrest phases; induction, maintenance, rewarming and post warming .Additionally, a post cardiac arrest consult team was created to support clinicians, as well as the construction of a post cardiac arrest steering committee to review outcomes and propose next steps.

Results/Outcomes: The percentage of eligible patients post cardiac arrest receiving therapeutic hypothermia increased from 25% in 2006 to 100% in 2011. Time to initiation of therapy decreased from 5 hours in 2009 to 2 hours and 30 minutes in 2011. Time to target temperature goal reported at 10 hours in 2009, decreased to 7 hours in 2011. Good neurologic outcomes (cerebral performance category 1 or 2) at discharge was 24% in 2009 and increased to 38% of patients in 2011.

Implications: Post cardiac arrest syndrome is complex and requires the commitment of frontline staff to initiate clinical guidelines in addition to cross departmental collaboration. Supporting the mission of the center our team focused on breaking down departmental silos of post cardiac arrest care to a patient focused approach; following the patient through the continuum of care despite location. Through this work the Post Cardiac Arrest Center has grown and evolved into the Center for Resuscitation Science. We recognize the need for further inquiry in the following areas: inpatient cardiac arrest consults, glycemic control, hemodynamic management, outcome prognostication, patient and family education tools, and a visible social support system.

Keywords:
Post-cardiac Arrest Center
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleFrom Door to Recovery: A Collaborative Approach to the Development of a Post Cardiac Arrest Centeren_GB
dc.contributor.authorCalder, Shelleyen_GB
dc.contributor.authorWilliams, Donnaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsShelley Calder, MSN, RN, CEN, scalder@bidmc.harvard.edu; Donna Williams, MS, BSN, RN, CCRNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306557-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Each year 325,000 Americans experience pre hospital cardiac arrest. Centers treating a higher volume of post cardiac arrest patients, in addition to having comprehensive treatment guidelines, demonstrate decreased mortality and improved patient outcomes. The purpose of this quality improvement project was to improve post cardiac care using a multi-disciplinary, collaborative approach. Critical care and emergency medicine physicians and nurse leaders developed and implemented clinical guidelines, staff and patient education, and ultimately a cardiac arrest center.</p><p>Design: This prospective QI project started in 2006 and is ongoing. The mission, guiding the development of a Cardiac Arrest Center was: to provide excellence in the clinical care of post cardiac arrest patients, provide education for the management of the post cardiac arrest patient, and perform quality research related to all aspects of post cardiac arrest syndrome.</p><p>Setting: A Level I, university-affiliated, teaching hospital with 420 licensed beds, includes: 54 emergency care beds and a total of 62 critical care beds.</p><p>Participants /Subjects: A multidisciplinary team consisting of physicians, clinical nurse specialists, front line staff and research assistants from critical care, emergency department and cardiology.</p><p> Methods: Interventions included: Identification of key stakeholders, provision of education on post resuscitation care based on professional guidelines/recommendations, selection of safe standardized equipment for cooling and temperature management, development of guidelines/policies for post cardiac arrest management supported by documentation tools and order sets, designation of post cardiac arrest phases; induction, maintenance, rewarming and post warming .Additionally, a post cardiac arrest consult team was created to support clinicians, as well as the construction of a post cardiac arrest steering committee to review outcomes and propose next steps.</p><p>Results/Outcomes: The percentage of eligible patients post cardiac arrest receiving therapeutic hypothermia increased from 25% in 2006 to 100% in 2011. Time to initiation of therapy decreased from 5 hours in 2009 to 2 hours and 30 minutes in 2011. Time to target temperature goal reported at 10 hours in 2009, decreased to 7 hours in 2011. Good neurologic outcomes (cerebral performance category 1 or 2) at discharge was 24% in 2009 and increased to 38% of patients in 2011.</p><p>Implications: Post cardiac arrest syndrome is complex and requires the commitment of frontline staff to initiate clinical guidelines in addition to cross departmental collaboration. Supporting the mission of the center our team focused on breaking down departmental silos of post cardiac arrest care to a patient focused approach; following the patient through the continuum of care despite location. Through this work the Post Cardiac Arrest Center has grown and evolved into the Center for Resuscitation Science. We recognize the need for further inquiry in the following areas: inpatient cardiac arrest consults, glycemic control, hemodynamic management, outcome prognostication, patient and family education tools, and a visible social support system.</p>en_GB
dc.subjectPost-cardiac Arrest Centeren_GB
dc.date.available2013-12-09T16:59:44Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:44Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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