@article{54bc1716b4d448f0a9c1e6fa604120ff,
title = "Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role",
abstract = "Aim: Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. Methods: We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Results: Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (p<. 0.001). Accurate estimation of CPR quality was poor for chest compression depth (0-13%), rate (5-46%) and chest compression fraction (60-63%). Perception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p= 0.043) when using real-time feedback. Conclusion: Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training.",
keywords = "Cardiopulmonary resuscitation, Chest compressions, Perception, Quality, Resuscitation",
author = "{International Network for Simulation-based Pediatric Innovation, Research, Education (INSPIRE) CPR Investigators} and Adam Cheng and Frank Overly and David Kessler and Nadkarni, {Vinay M.} and Yiqun Lin and Quynh Doan and Duff, {Jonathan P.} and Tofil, {Nancy M.} and Farhan Bhanji and Mark Adler and Alex Charnovich and Hunt, {Elizabeth A.} and Brown, {Linda L.} and Jennifer Davidson and Peterson, {Dawn Taylor} and White, {Marjorie Lee} and John Zhong and Vincent Grant and David Grant and Stephanie Sudikoff and Kimberly Marohn and Nicola Robertson and Jordan Duval-Arnould and Ilana Bank and Ronald Gottesman and Hubert Wong and Aaron Donoghue and Sutton, {Robert M.} and Dana Niles and Jenny Chatfield and Nnenna Chime",
note = "Funding Information: Adam Cheng (study design, data collection and analysis, writing, editing and reviewing of manuscript) received funding from the Heart and Stroke Foundation of Canada and the Canadian Institute for Health Research to conduct this study. Vinay Nadkarni (study design, writing, editing and review of manuscript) is supported by: Endowed Chair, Critical Care Medicine, Children's Hospital of Philadelphia; and the following research grants: AHRQ RO3HS021583; Nihon Kohden America Research Grant; NIH/NHLBI RO1HL114484; NIH U01 HL107681; NIH/NHLBI 1U01HL094345-01; and NIH/NINDS 5R01HL058669-10. Nancy Tofil (study design, writing, editing, review of manuscript) was a speaker at the fall 2013 Laerdal Conference and spoke using her own created materials, did not receive a speaker stipend, but was reimbursed for travel. Robert Sutton (study design, writing, editing and review of manuscript) receives funding in the form of a National Institute of Child Health and Human Development (NICHD) Career Development Award (K23HD062629). He has previously received a speaker honoraria from Zoll Medical. Elizabeth Hunt (study design, writing, editing and review of manuscript) is supported by: Drs. David S. and Marilyn M. Zamierowski Endowed Directorship, Johns Hopkins Medicine Simulation Center and grants from the Laerdal Foundation for Acute Care Medicine and the Hartwell Foundation. The remaining authors have no financial disclosures of conflict of interests relevant to this article. Publisher Copyright: {\textcopyright} 2014 Elsevier Ireland Ltd.",
year = "2015",
month = feb,
day = "1",
doi = "10.1016/j.resuscitation.2014.11.015",
language = "English (US)",
volume = "87",
pages = "44--50",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
}