Background:Survival outcomes following in-hospital cardiac arrest vary significantly across hospitals. Research suggests clinician education and training may play a role. We sought to identify best practices related to the education and training of resuscitation teams.Methods:We conducted a descriptive qualitative analysis of semistructured interview data obtained from in-depth site visits conducted from 2016 to 2017 at 9 diverse hospitals within the American Heart Association “Get With The Guidelines” registry, selected based on in-hospital cardiac arrest survival performance (5 top-, 1 middle-, 3 low-performing). We assessed coded data related to education and training including systems learning, informal feedback and debrief, and formal learning through advanced cardiopulmonary life support and mock codes. Thematic analysis was used to identify best practices.Results:In total, 129 interviews were conducted with a variety of hospital staff including nurses, chaplains, security guards, respiratory therapists, physicians, pharmacists, and administrators, yielding 78 hours and 29 minutes of interview time. Four themes related to training and education were identified: engagement, clear communication, consistency, and responsive leadership. Top-performing hospitals encouraged employee engagement with creative marketing of new programs and prioritizing hands-on learning over passive didactics. Clear communication was accomplished with debriefing, structured institutional review, and continual, frequent education for departments. Consistency was a cornerstone to culture change and was achieved with uniform policies for simulation practice as well as reinforced, routine practice (weekly, monthly, quarterly). Finally, top-performing hospitals had responsive leadership teams across multiple disciplines (nursing, respiratory therapy, pharmacy and medicine), who listened and adapted programs to fit the needs of their staff.Conclusions:Among top-performing hospitals excelling in in-hospital cardiac arrest survival, we identified core elements for education and training of resuscitation teams. Developing tools to expand these areas for hospitals may improve in-hospital cardiac arrest outcomes.

中文翻译：

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院内心脏骤停复苏团队教育和培训的最佳实践

背景：院内心脏骤停后的生存结果因医院而异。研究表明，临床医生教育和培训可能发挥作用。我们试图确定与复苏团队的教育和培训相关的最佳实践。方法：我们对 2016 年至 2017 年在美国心脏协会 9 家不同医院进行的深入现场访问中获得的半结构化访谈数据进行了描述性定性分析“ Get With The Guidelines” 注册表，根据院内心脏骤停存活率选择（5 个表现最好，1 个表现中等，3 个表现不佳）。我们评估了与教育和培训相关的编码数据，包括系统学习、非正式反馈和汇报，以及通过高级心肺生命支持和模拟代码进行的正式学习。主题分析用于确定最佳实践。结果：总共对包括护士、牧师、保安、呼吸治疗师、医生、药剂师和管理人员在内的各种医院工作人员进行了 129 次采访，采访时间为 78 小时 29 分钟时间。确定了与培训和教育相关的四个主题：参与、清晰的沟通、一致性和响应式领导。表现最好的医院鼓励员工参与新项目的创意营销，并将动手学习置于被动教学之上。通过汇报、结构化的机构审查以及对部门的持续、频繁的教育，实现了清晰的沟通。一致性是文化变革的基石，通过统一的模拟实践政策以及强化的常规实践（每周、每月、每季度）实现。最后，表现最好的医院拥有跨多个学科（护理、呼吸治疗、药学和医学）的响应迅速的领导团队，他们倾听并调整计划以满足员工的需求。结论：表现最好的医院在院内心脏疾病方面表现出色逮捕生存，我们确定了复苏团队教育和培训的核心要素。开发工具来扩大医院的这些领域可能会改善院内心脏骤停的结果。pharmacy and medicine)，他们倾听并调整计划以满足员工的需求。结论：在院内心脏骤停存活率方面表现出色的顶级医院中，我们确定了复苏团队教育和培训的核心要素。开发工具来扩大医院的这些领域可能会改善院内心脏骤停的结果。pharmacy and medicine)，他们倾听并调整计划以满足员工的需求。结论：在院内心脏骤停存活率方面表现出色的顶级医院中，我们确定了复苏团队教育和培训的核心要素。开发工具来扩大医院的这些领域可能会改善院内心脏骤停的结果。