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  1. Article ; Online: Barriers to the Initiation of Telecommunicator-CPR during 9-1-1 Out-of-Hospital Cardiac Arrest Calls: A Qualitative Study.

    Missel, Amanda L / Dowker, Stephen R / Chiola, Madeline / Platt, Jodyn / Tsutsui, Julia / Kasten, Kristin / Swor, Robert / Neumar, Robert W / Hunt, Nathaniel / Herbert, Logan / Sams, Woodrow / Nallamothu, Brahmajee K / Shields, Theresa / Coulter-Thompson, Emilee I / Friedman, Charles P

    Prehospital emergency care

    2023  Volume 28, Issue 1, Page(s) 118–125

    Abstract: Introduction: Fewer than 10% of individuals who suffer out-of-hospital cardiac arrest (OHCA) survive with good neurologic function. Bystander CPR more than doubles the chance of survival, and telecommunicator-CPR (T-CPR) during a 9-1-1 call ... ...

    Abstract Introduction: Fewer than 10% of individuals who suffer out-of-hospital cardiac arrest (OHCA) survive with good neurologic function. Bystander CPR more than doubles the chance of survival, and telecommunicator-CPR (T-CPR) during a 9-1-1 call substantially improves the frequency of bystander CPR.
    Objective: We examined the barriers to initiation of T-CPR.
    Methods: We analyzed the 9-1-1 call audio from 65 EMS-treated OHCAs from a single US 9-1-1 dispatch center. We initially conducted a thematic analysis aimed at identifying barriers to the initiation of T-CPR. We then conducted a conversation analysis that examined the interactions between telecommunicators and bystanders during the recognition phase (i.e., consciousness and normal breathing).
    Results: We identified six process themes related to barriers, including incomplete or delayed recognition assessment, delayed repositioning, communication gaps, caller emotional distress, nonessential questions and assessments, and caller refusal, hesitation, or inability to act. We identified three suboptimal outcomes related to arrest recognition and delivery of chest compressions, which are missed OHCA identification, delayed OHCA identification and treatment, and compression instructions not provided following OHCA identification. A primary theme observed during missed OHCA calls was incomplete or delayed recognition assessment and included failure to recognize descriptors indicative of agonal breathing (e.g., "snoring", "slow") or to confirm that breathing was effective in an unconscious victim.
    Conclusions: We observed that modifiable barriers identified during 9-1-1 calls where OHCA was missed, or treatment was delayed, were often related to incomplete or delayed recognition assessment. Repositioning delays were a common barrier to the initiation of chest compressions.
    MeSH term(s) Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation ; Emergency Medical Services ; Emergency Medical Service Communication Systems ; Emergency Medical Dispatch
    Language English
    Publishing date 2023-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.1080/10903127.2023.2183533
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Bridging the Communication Gap: A Quality Improvement Project of a Ventricular Assist Device Program.

    Griffith, Andy / Haverstick, Stacy / Blissick, Deb / Colaianne, Teresa / Shields, Heidi / Johnson, Caty / Lucier, Rená / Melong, Mary Jane / Kasten, Kristin / Knott, Kevin

    Dimensions of critical care nursing : DCCN

    2019  Volume 39, Issue 1, Page(s) 4–11

    Abstract: Background: As of December 31, 2016, in the United States, 22 866 patients received left ventricular assist devices (LVADs) (J Heart Lung Transplant. 2017;36(10):1080-1086). First responders are generally unfamiliar with LVAD equipment functionality (J ... ...

    Abstract Background: As of December 31, 2016, in the United States, 22 866 patients received left ventricular assist devices (LVADs) (J Heart Lung Transplant. 2017;36(10):1080-1086). First responders are generally unfamiliar with LVAD equipment functionality (J Heart Lung Transplant. 2018;37(4):S275). When a patient has an emergency either clinically or with a controller alarm or failure, speaking with ventricle assist device (VAD)-trained personnel is imperative to the prevention of adverse events. Starting February 2017, an LVAD program totaling 181 patients at a large teaching hospital changed their afterhours process to reduce wait time between patient call and talking to VAD-trained personnel to increase patient safety and patient satisfaction.
    Methods: The Plan-Do-Check-Act quality improvement method was used to evaluate this project from February 2017 to July 2018 by the program's clinical information analyst. An afterhours summary of telephone interactions between VAD program clinicians (VAD coordinators, physician assistants, and nurse practitioner) was used to analyze the use of the "VAD Emergency Line." An annual patient satisfaction survey was completed to analyze patient satisfaction of the VAD Emergency Line.
    Interventions: Review of the afterhours summary was conducted to determine the use of the VAD Emergency Line. The process of afterhours patient calls was changed so that calls are answered immediately by a 24-hour LVAD-trained medical ambulance service, called VAD Emergency Line. Patient use of the VAD Emergency Line was continuously assessed. In November 2017, it was recognized that only 57% of patient calls used the VAD Emergency Line, and further intervention was needed. In November 2017, patients were provided visual reminders to ensure compliance.
    Results: Seventeen months after the implementation of the VAD Emergency Line, 92% of patient's afterhours calls were through the VAD Emergency Line. Although there was no statistical significance found, there was clinical significance. Since the implementation of the VAD Emergency Line, patient use of the VAD Emergency Line increased 56% from March 2017 to July 2018. There have been zero adverse safety events. Sixty-one percent of patients strongly agreed to the question "You are able to communicate emergent needs after hours (VAD Emergency Line)?
    Conclusion: Implementation of the LVAD Emergency Line has improved communication between patients in the outpatient setting. This increased patient safety by allowing patients to speak to LVAD-trained first responders and VAD coordinator personnel immediately without ever being put on hold. This communication process can be applied to other clinical programs.
    MeSH term(s) After-Hours Care/standards ; Algorithms ; Communication ; Emergency Medical Services/standards ; Heart Failure/therapy ; Heart-Assist Devices ; Hospitals, University ; Humans ; Patient Education as Topic ; Patient Safety ; Patient Satisfaction ; Quality Improvement ; Root Cause Analysis
    Language English
    Publishing date 2019-12-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632780-1
    ISSN 1538-8646 ; 0730-4625
    ISSN (online) 1538-8646
    ISSN 0730-4625
    DOI 10.1097/DCC.0000000000000397
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 2895: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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