Implementing the American Heart Association 2020 guidelines for cardiac arrest in an urgent care setting

Abstract

This quality improvement project seeks to match a clinic's preparedness for cardiac resuscitation with current American Heart Association standards. Through a review of current literature, this project describes several key actions in the management of cardiac arrest, which include having an emergency preparedness plan, staff competency and trainings, the provision of rapid defibrillation, the administration of resuscitation medications, and the importance of data registry for continuous improvement to processes. Recommendations for the clinic have been developed based on the literature review and an analysis of the setting. Recommendations will be shared with the clinic's leadership and advise the development of detailed Standard Operating Procedures which translate the American Heart Association guidelines into this practice setting. Recommended actions include staff BLS and ACLS trainings, continuous short interval trainings, and the acquisition of useful, non-expired equipment. Data collection consists of an auditing of staff certifications and available resuscitation equipment and medications, as well as protocols in place. Results: 100% of medical staff were BLS trained, and 100% of providers were ACLS trained. 100% of resuscitation medications and crash cart equipment was updated, with exception of the defibrillator. 0% of SOPs were adopted into practice. Conclusion: The declination of SOPs is predicted to greatly affect the sustainability of outcomes related to this project. Although there is value in the AHA BLS and ACLS trainings, without continued short interval trainings these skills are likely to decay in a matter of months. Further, there is no policy to direct staff to be retrained again in two years when certifications expire. Although an updated checklist for equipment was provided to the clinic manager, no policy is in place for routinely outdating medications and replacing them or ensuring that equipment is in a functional state. Use of motivational interviewing with key stakeholders may encourage behavioral changes to improve health outcomes, and thus further the outreach of a quality improvement endeavor.