Abstract 9443: Improving Time to Defibrillation Following Ventricular Fibrillation and Ventricular Tachycardia Cardiac Arrest at Thomas Jefferson University Hospital

Problem Definition: Defibrillation within 2 minutes after ventricular fibrillation (VFib) and ventricular tachycardia (VTach) cardiac arrest has improved survival to discharge and five-year survival rates. The goal of this study was to identify how often patients were defibrillated within this recommended 2-minute interval at a single institution. A retrospective chart review of the code blue database over a 21-month time period revealed 24 VFib/VTach cardiac arrests. Time to defibrillation for each event, defined as time of identification of VFib/VTach arrest to time of delivery of the first defibrillation, was calculated. Approximately 67% (22/34) of patients who experienced VFib/VTach arrest were not defibrillated within 2 minutes and 8% (3/34) did not receive defibrillation at all. The data was further stratified based on event location (ICU versus non-ICU) and compared using chi-squared analysis, with statistical significance defined as p<0.05. A significantly higher number of delayed defibrillations occurred in the non-ICU cohort compared to the ICU cohort (11/34 versus 3/34, p=0.0028). Intervention: We utilized code blue simulation sessions and an educational module to train nursing staff, who are often first at bedside, to promptly defibrillate VFib/VTach. Methods: 36 nurses out of 53 ACLS certified nurses were recruited from a single nursing unit. Groups of 2 or 3 nurses completed code blue simulation sessions to establish a baseline time to defibrillation. They were then given 2 weeks to complete an assigned educational module. Upon completion, they will be brought in for a second round of simulation sessions to assess whether their time to defibrillation has improved. Results: Out of the 15 simulation sessions that were done in the first round, 33% (5/15) ended with delayed defibrillation and 27% (4/15) ended with no defibrillation. The simulation data correlated with the retrospective chart review data. Next Steps: The second round of simulation sessions will take place in two weeks. Post-intervention data will be collected and analyzed to determine if the nursing educational module was effective. If it is, we hope to make the simulation sessions and educational module a hospital-wide initiative to improve time to defibrillation.