Initial implementation of the resuscitation quality improvement program in emergency department of a teaching hospital in China

BACKGROUND: Cardiopulmonary resuscitation (CPR) skills may decay over time after conventional instructor-led BLS training. The Resuscitation Quality Improvement® (RQI®) program, unlike a conventional basic life support (BLS) course, is implemented through mastery learning and low-dose, high-frequency training strategies to improve CPR competence. We facilitated the RQI program to compare the performance of novices vs those with previous BLS training experience before RQI implementation and to obtain their confidence and attitude of the RQI program. METHODS: A single-center observational study was conducted from May 9, 2021 to June 25, 2021 in an emergency department of a tertiary hospital. The performance assessment data of both trainees with a previous training experience in conventional BLS course (BLS group) and the novice ones with no prior experience with any BLS training (Non-BLS group) was collected by RQI cart and other outcome variables were rated by online questionnaire. Outcome measurements included chest compression and ventilation in both adult-sized and infant-sized manikins. RESULTS: A total of 149 participants were enrolled. Among them, 103 participants were in BLS group and 46 participants in Non-BLS group. Post RQI training, all the trainees achieved a passing score of 75 or more, and obtained an improvement in CPR performance. The number of attempts to pass RQI for compression and ventilation practice was lower in the BLS group in both adult and infant training sessions (P < 0.05). Although the BLS group had a poor baseline, it had fewer trials and the same learning outcomes, and the BLS group had better self-confidence. Trainees were well adapted to the innovative training modality, and satisfaction among all of the participants was high. Only the respondents for non-instructor led training, the satisfaction was low in both groups (72.8% in BLS group vs 65.2% in No-BLS group, strongly agreed). CONCLUSION: Among novices, RQI can provide excellent CPR core skills performance. But for those who had previous BLS training experience, it was able to enhance the efficiency of the skills training with less time consumption. Most trainees obtained good confidence and satisfaction with RQI program, which might be an option for the broad prevalence of BLS training in China.