Abstract 4141869: Effects of Compliant Chest Compression Rate on Return of Spontaneous Circulation in In-Hospital-Cardiac-Arrest

Introduction: Over 290,000 in-hospital cardiac arrests occur annually in the United States. Survival is about 25% with significant variation across the country. Evidence supports high-quality chest compressions as a vital factor to achieving return of spontaneous circulation (ROSC) and improving outcomes after cardiac arrest. Research illustrates a propensity for healthcare professionals to provide chest compressions at a rate outside the American Heart Association guideline of 100-120 compressions/minute. Goal/Hypothesis: The team hypothesized greater compliance with chest compression rate guidelines would increase ROSC. The goal of this initiative was to increase CC rate compliance from a facility baseline of 15-64% toward the published benchmark of 80%, and to positively impact ROSC. Method: An interdisciplinary team focused on optimizing CC rate compliance. The Plan, Do, Study, Act methodology provided structure and a systematic approach to data informed improvements. Rate data was collected, then shared on a Power BI dashboard and in a facility specific report. The impact of the awareness campaign was assessed at the end of each quarterly cycle for 9 facilities. Results/Outcomes: Data for 2023 included 487 code events and 6,315 minutes of CPR. At year end, improvements were found at 5 facilities (12, 12, 14, 17,&7%) over baseline, and 2 facilities achieved the benchmark. Statistical analysis was conducted to evaluate CC rate compliance in correlation with ROSC. Cases were sorted into 2 groups: Group 1 (compliance 80% or greater) or Group 2 (compliance less than 31.6% - calculated first quartile). Three hundred two cases met inclusion criteria. Cochran’s formula was used (95% CI) to calculate sample size (Group 1:111 cases; Group 2:107cases). A Chi-squared test showed a significant difference in achieving ROSC between the groups (p=0.0223). Group 1 achieved ROSC 20% more frequently than Group 2. Conclusions: Chest compression rate compliance was positively associated with improved rate of ROSC in this project. Project findings prompted the system resuscitation committee to require facilities to set a goal for CC rate compliance improvement. Improvement can be achieved without financial or educational burden. Other performance-based quality metrics to improve clinical outcomes should be included in future research with consideration of co-morbidities.