A structured educational intervention to improve targeted temperature management utilization after cardiac arrest

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• 作者：Audrey L. Blewer ; MPH ; Gail Delfin ; MSN ; RN ; Marion Leary ; BSN ; RN ; David F. Gaieski ; MD ; Benjamin S. Abella ; MD ; MPhil ; ^{benjamin.abella@uphs.upenn.edu}
• 关键词：Cardiac arrest ; Therapeutic hypothermia ; Targeted temperature management ; Simulation
• 刊名：Journal of Critical Care
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：28
• 期：3
• 页码：259-264
• 全文大小：433 K

文摘

Purpose

Post-arrest targeted temperature management (TTM) has been shown to dramatically improve outcomes after resuscitation, yet studies have revealed inconsistent and slow adoption. Little is known about barriers to TTM implementation and methods to increase adoption. We hypothesized that a structured educational intervention might increase TTM use.

Materials and Methods

Subjects participated in mixed quantitative/qualitative surveys before and after attending a series of TTM educational courses from October 2010 to October 2011, to determine usage and barriers to implementation. A knowledge examination was also administered to participants before and after the course.

Results

Clinicians completed 227 surveys (129 pre-training and 98 post-training) and 343 exams (165 pre-training and 178 post-training). A ranking survey (score range 1-7; 7 as most challenging) found that communication challenges (mean score 4.7 ¡À 1.5) and lacking adequate education (4.3 ¡À 1.9) were the 2 most emphasized barriers to implementation. Post-survey results found that 95 % (93/98) of respondents felt more confident initiating TTM post-intervention. There was a statistically significant increase in self-reported TTM usage after participation in the program (P < .01).

Conclusions

A focused TTM program led to increased confidence and usage among participants. Future work will focus on targeted training to address specific barriers and increase TTM utilization.