Invasive Cardiology BLS/ACLS Resuscitation Quality Improvement (RQI)

Saturday, 23 February 2019

Linda M. Turner, MSN
Invasive Cardiology, Cleveland Clinic-Fairview, Cleveland, OH, USA

Background of the Problem

With approximately 80 staff in our department renewing BLS and ACLS annually is costly and taking time away from the cardiac cath lab schedule traveling due to find an available class; many times taking an entire day off for renewals, which left unit shortages. There were numerous BLS/ACLS expired cards due to scheduling problems, which required a two-day certification class.

Staff were disgruntled on the inability to schedule renewal classes citing lack of easily accessible classes as one reason for this. Our goal was to improve the BLS/ACLS re-certification compliance by providing the learning experience in an easily accessible location where staff can participate in the megacode in a familiar hospital-setting and enhance staff’s hands-on learning of the megacode.

Literature Review

American Heart Association (AHA) RQI Program shows better student performance leads to better patient outcomes and Brennen, et al (2016) shows reinforcement of skills, use of real-time feedback, and debriefing assists students to retain skills and remain competent. Research shows class participants should have adequate hands-on practice in real-world environments on a hospital bed focusing on their psychomotor skills for successful course completion and use of feedback and debriefing assists students to retain skills and remain competent. It has also been shown that h fidelity simulation (HFS) significantly improved student’s knowledge and psychomotor skills.

Objectives/Purpose

Our purpose is to provide an alternative way to schedule renewal BLS/ACLS classes for our employees making it easier to attend monthly BLS/ACLS classes in the department, requiring less staff inconvenience, and improving attendance. The overall objectives are:

  • Decrease frustration scheduling a BLS/ACLS class
  • Provide advance notice of a scheduled class
  • Minimal unit disruption
  • Adequate time allowed to practice skills
  • Feeling competent with BLS/ACLS skills
  • Greater participation in a relaxed atmosphere
  • No expired BLS/ACLS cards
  • Team-based learning

Methods

Caregivers focused on education specifically for the BLS/ACLS intradepartmental experienced provider renewal program resulted in department discussion wanting to create a program to reduce the following:

  • Taking time away from the cath lab patient schedule
  • Travel time needed to find class space
  • An entire day needed away from patient care
  • Expired cards requiring a two day class
  • Staffing shortages in the department

This resulted in the department formation of the combined BLS/ACLS renewal class consisting of a BLS/ACLS class held monthly with a survey detailing student response to ease of scheduling and competency of performance. Each month six staff members are scheduled to attend based on expiration of BLS/ACLS certification; staff still have the option of taking an enterprise-based class. We offer the BLS only class twice annually as well for those staff not ACLS certified and have no issues with expired cards to date.

Outcomes

We are in the process of measuring post-intervention data after delivering classes in January, February, March, April, and June this year although all favorable with students indicating feeling competent performing BLS/ACLS protocols and having adequate time practicing skills learned also detailing:

  • ease of scheduling
  • competency of performance
  • class rating on a 1-5 scale for overall best class compared to other classes taken

Conclusion

Providing alternative scheduling for renewals may enhance attendance and improve overall compliance noting that compliance improves when courses are easily accessible, thus it may be important to consider having more decentralized locations for mandatory courses that staff is expected to complete yearly. In our experience, improving accessibility has improved compliance.

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