Articles-Thought Leadership Improving Resuscitation throughout the Care Contin | Page 3

• Varying states of acuity among patients and residents:
Haynes points first to the most obvious challenge for
resuscitation across the continuum—the acuity of
patients, which can vary widely by setting. Although
codes are more common in acute-care settings, patient
acuity levels are climbing and becoming more complex
across all care settings, creating an increased need to
improve resuscitation training.
• A wide range of lengths of stay: Patients may stay
one day to one week for an outpatient procedure
or up to several months at a long-term/residential
care facility
• Inconsistent knowledge at provider of patient
medical history: Due to the varying lengths of stay,
the staff may not have full knowledge of the patient’s
medical history. For example, less is typically known
about the patient in an ambulatory surgery center
prior to a procedure than would be known in an
acute-care setting.
• Infrequent Codes: The good news is that
Codes occur less frequently in settings outside the
hospital and EMS. But that’s also the bad news! CPR
skills that are refreshed just once every two years
are unlikely to result in high-quality, life-saving CPR.
In 2015, the resuscitation guidance to healthcare
providers on CPR training was updated. As Alex
Harris, HealthStream Solution Executive for
Resuscitation, puts it, “If you don’t use it, you lose it.”
Studies show that CPR skills begin to decay in as
little as three months. However, healthcare leaders
know the skill and experience of their workforce
best and should have the ability to adjust practice
frequency based on audience or student group,
whether that’s three, six, 12 or 24 months. Harris
adds, “Just like their acute-care counterparts,
providers across the continuum of care need to
receive the highest quality CPR training available and
should receive it in a way that is easily accessible and
readily available at all times.”
Elements of a Successful Resuscitation
Program—the Must-Haves
As leaders across the care continuum plan to provide
higher quality CPR training, what should they do to lay
the foundation for success? Haynes shared these must-
haves for moving toward a more rigorous resuscitation-
training program.
• Support from leadership: Chief nursing
officers, directors of nursing, directors of
education, and staff alike are aware of the
increasing acuity levels of patients across the
continuum of care. While it is certainly true that a
patient who codes outside the hospital will be
transferred to an acute-care facility, these leaders
and their staff also know that what happens in the
first few minutes of that Code really matter.
Providing high-quality CPR is a differentiator and
no less important outside the hospital.
• Effective communication: Building skills will also
build staff confidence, and so will communication.
“Working as a team to clearly communicate what is
happening during the code and communicating all
that is known of the patient’s history are key
elements of a successful code, regardless of the
setting,” said Haynes.
• Resource replacement: Haynes stresses the
importance of keeping the manikins and any other
equipment in good working order to provide the
optimal student experience and the highest quality
training. Manikins need to be maintained and
replaced periodically.
• Change management strategy: Haynes affirms that
building support for any change to a higher quality
resuscitation training program is imperative. She
encourages leaders to manage this change as they
would any other change that would affect
employees. Nurse educators are often in a position
to be able to recruit super-users who can serve as
both advocates for the new training modality and as
subject matter experts.