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J Hosp Med. 2014 Jun;9(6):353-7. doi: 10.1002/jhm.2174. Epub 2014 Feb 19.

Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.

Author information

1
Department of Medicine, University of Chicago, Chicago, Illinois.

Abstract

BACKGROUND:

In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals.

OBJECTIVE:

To describe current US hospital practices with regard to resuscitation care.

DESIGN:

A nationally representative mail survey.

SETTING:

A random sample of 1000 hospitals from the American Hospital Association database, stratified into 9 categories by hospital volume tertile and teaching status (major teaching, minor teaching, and nonteaching).

SUBJECTS:

Surveys were addressed to each hospital's cardiopulmonary resuscitation (CPR) committee chair or chief medical/quality officer.

MEASUREMENTS:

A 27-item questionnaire.

RESULTS:

Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (P = 0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a hospitalist. High frequency practices included having a rapid response team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least 1 barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common.

CONCLUSIONS:

There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.

PMID:
24550202
PMCID:
PMC4144704
DOI:
10.1002/jhm.2174
[Indexed for MEDLINE]
Free PMC Article

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