CPR Quality Officer role to improve CPR quality: A multi-centred international simulation randomised control trial

Kacper Sumera; Tomasz Ilczak; Morten Bakkerud; Jon Dearnley Lane; Jeremy Pallas; Sandra Ortega Martorell; Agnieszka Sumera; Carl A Webster; Tom Quinn; John Sandars; A Niroshan Siriwardena

doi:10.1016/j.resplu.2023.100537

CPR Quality Officer role to improve CPR quality: A multi-centred international simulation randomised control trial

Resusc Plus. 2024 Jan 2:17:100537. doi: 10.1016/j.resplu.2023.100537. eCollection 2024 Mar.

Authors

Kacper Sumera^{1

2}, Tomasz Ilczak^{3

2}, Morten Bakkerud^{4

2}, Jon Dearnley Lane⁵, Jeremy Pallas⁶, Sandra Ortega Martorell⁷, Agnieszka Sumera^{8

2}, Carl A Webster^{9

2}, Tom Quinn^{10

2}, John Sandars⁵, A Niroshan Siriwardena^{11

2}

Affiliations

¹ East Midlands Ambulance Service NHS Trust, Education, Nottingham NG11 8NS, UK.
² European Pre-hospital Research Network, United Kingdom.
³ Department of Emergency Medicine, Faculty of Health Sciences, University of Bielsko-Biała, Poland.
⁴ Oslo Metropolitan University, Department of Nursing and Health Promotion, Pilestredet 32, 0166 Oslo, Norway.
⁵ Edge Hill University, Allied Health, Social Work & Wellbeing, Ormskirk L39 4QP, UK.
⁶ John Hunter Hospital, Emergency Department, NSW 2305, Australia.
⁷ Liverpool John Moores University, School of Computer Science and Mathematics, Liverpool L3 5UX, UK.
⁸ University of Chester, Faculty of Health, Medicine & Society, Chester CH1 1SL, UK.
⁹ Nottingham Trent University, Institute of Health and Allied Professions, Nottingham NG11 8NS, UK.
¹⁰ Kingston University & St George's, University of London, Centre for Health and Social Care Research, London KT2 7LB, UK.
¹¹ University of Lincoln, School of Health and Social Care, Lincoln LN6 7TS, UK.

Abstract

Background: An out-of-hospital cardiac arrest requires early recognition, prompt and quality clinical interventions, and coordination between different clinicians to improve outcomes. Clinical team leaders and clinical teams have high levels of cognitive burden. We aimed to investigate the effect of a dedicated Cardio-Pulmonary Resuscitation (CPR) Quality Officer role on team performance.

Methods: This multi-centre randomised control trial used simulation in universities from the UK, Poland, and Norway. Student Paramedics participated in out-of-hospital cardiac arrest scenarios before randomisation to either traditional roles or assigning one member as the CPR Quality Officer. The quality of CPR was measured using QCPR® and Advanced Life Support (ALS) elements were evaluated.

Results: In total, 36 teams (108 individuals) participated. CPR quality from the first attempt (72.45%, 95% confidence interval [CI] 64.94 to 79.97) significantly increased after addition of the CPR Quality role (81.14%, 95% CI 74.20 to 88.07, p = 0.045). Improvement was not seen in the control group. The time to first defibrillation had no significant difference in the intervention group between the first attempt (53.77, 95% CI 36.57-70.98) and the second attempt (48.68, 95% CI 31.31-66.05, p = 0.84). The time to manage an obstructive airway in the intervention group showed significant difference (p = 0.006) in the first attempt (168.95, 95% CI 110.54-227.37) compared with the second attempt (136.95, 95% CI 87.03-186.88, p = 0.1).

Conclusion: A dedicated CPR Quality Officer in simulated scenarios improved the quality of CPR compressions without a negative impact on time to first defibrillation, managing the airway, or adherence to local ALS protocols.

Keywords: CPR quality; Out-of-hospital cardiac arrest; Quality Officer; Resuscitation.