Improving role allocation for cardiopulmonary resuscitation (CPR) in the emergency department: a quality improvement project.

Abstract

In any healthcare setting, cardiopulmonary resuscitations (CPRs) stand out as demanding and chaotic resuscitation endeavours. Emergency departments (EDs) witness a significant volume of CPRs. Given the critical nature of CPR, content knowledge and procedural skills alone fall short in delivering optimal care. Effective teamwork, complemented by a well-coordinated response, is imperative for achieving favourable patient outcomes. A survey conducted in our ED highlighted that while the majority of staff acknowledged the significance of teamwork in CPR and were aware of the whiteboard for assigning team roles, only 19% were familiar with their individual roles during CPR. To address this gap, our project aimed to increasing the role delegation for CPR from 19% to 80% within 2 months. We formed an interprofessional team and implemented strategies through four plan-do-study-act cycles. Interventions encompassed increasing sensitisation, creating a simplified format for assigning team roles and entrusting the nursing team leader of each shift with the responsibility of role assignment for accountability. The sharing of progress charts for acknowledgment served as a motivating factor, leading to sustained adherence to the project goals without necessitating reminders in the final two weeks. This project proved to be highly successful as our process indicator steadily increased and remained above the target for 4 consecutive weeks. Our results underscore the importance of patience and teamwork in achieving project objectives. It serves as a good example of the efficiency of simple and cost-effective interventions, one that can be replicated and implemented in other EDs.