Intraoperative In-Situ Cardiac Arrest Simulation to Improve Technical and Non-Technical Skills in Operating Room Staff

Purpose of Project: This quality improvement project was designed to improve technical and non-technical skills of operating room staff members in the management of intraoperative cardiac arrests at a large academic medical center in New Jersey. Methodology: Participants were divided into two rooms with identical equipment to take part in an intraoperative cardiac arrest simulation. Key action items (KAIs) were timed and noted to measure technical skills. Teamwork performance was assessed and rated. A 15-minute debriefing and education session was held post-simulations. A subsequent simulation day occurred. Data comparing the results from day one and day two were compared and analyzed. Results: A time decrease was found in five out of six key action items, from day one to day two of the simulations. The independent samples t-test (t(10) = 2.092, p = 0.025) was statistically significant and demonstrated that the simulation was most likely the case of the time decrease. The key action item that resulted in the greatest time improvement was “first defibrillation shock”, with a decrease of 123 seconds. The assessment of teamwork performance between day one and day two did not produce consistent results. Implications for Practice: The time improvement of key action items, from day one to day two of the simulations, demonstrated better performance of the participants in the management of cardiac arrests. The time to “first defibrillation shock” decreased by approximately two minutes, equating to better neuronal tissue preservation and patient outcomes in a real-life scenario.