Implementation of cardiopulmonary resuscitation training for at-risk families

对高危家庭实施心肺复苏培训

• 批准号: 8514416
• 负责人: BENJAMIN S ABELLA
• 金额: $ 55.76万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-18 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8514416
• 关键词: Address; Blinded; Budgets; Cardiac; Cardiopulmonary Resuscitation; Cardiovascular system; Caring; Clinical; Clinical Data; Collaborations; Communities; Coronary heart disease; Cost Analysis; Data; Development; Direct Costs; Education; Enrollment; Environmental air flow; Event; Family; Family member; Fright; Goals; Hand; Health; Health Benefit; Heart Arrest; Home environment; Home visitation; Hospitals; House Call; Human Resources; Individual; Instruction; Knowledge; Learning; Life; Locales; Measures; Methods; Metric; Modeling; Motivation; Nursing Staff; Oral cavity; Outcome; Patients; Performance; Population; Populations at Risk; Public Health; Quality of life; Randomized; Reporting; Research; Rest; Resuscitation; Risk; Role; Science; Self Efficacy; Simulate; Site; Spouses; Survey Methodology; Surveys; Survivors; Testing; Time; Training; Training Programs; United States; Work; base; cohort; cost; empowered; experience; health belief; implementation trial; improved; innovation; loved ones; novel; opportunity cost; patient population; programs; skills; tool; volunteer; willingness

DESCRIPTION (provided by applicant): Prompt delivery of cardiopulmonary resuscitation (CPR) increases survival from sudden cardiac arrest (SCA) by 2-3 fold, yet most bystander-witnessed victims still die without an initial CPR attempt. There is a critical knowledge gap in our understanding of how to disseminate CPR training to at-risk populations. This is important as CPR delivery represents one of very few tools available to improve survival from SCA, which afflicts over 200,000 people in the United States each year. Individuals with coronary disease are at significantly increased risk of SCA, and greater than 75% of SCA events occur in the home environment. Taken together, these two observations highlight the opportunity to impact cardiovascular health by targeting CPR training to family members (and especially spouses) of patients hospitalized for complications of coronary disease. Current CPR training implementation largely fails to reach this at-risk demographic. Attempts to simplify CPR education and thereby broaden and increase training have led to the development of "hands- only" CPR, omitting the need for mouth-to-mouth ventilation. However, the preferred strategy for broad implementation is unknown. The long term goal of our work is to establish best practices for "real world" CPR dissemination that match training venues with at-risk populations, maximize resuscitation skill retention, and promote willingness to act. Towards this end, the goal of this application is to test two CPR educational strategies using a recently validated video-self instruction (VSI) CPR program in a hospital-based implementation program. Our central hypothesis is that hands-only CPR training will yield improved skills retention and address important training barriers when compared to standard CPR in this highly motivated at- risk population. As a dissemination project, a high degree of autonomy will be given to local stakeholders at each hospital to tailor the staff and enrollment approach at each site, and an important objective will be to learn from their implementation experiences. To test our central hypothesis, we will pursue the following Specific Aims in an eight hospital cohort: (1) Assess objective metrics of resuscitation skill retention at three months in subjects randomized to hands-only VSI CPR training versus standard VSI CPR. (2) Measure the perceived barriers and motivations to enrollment for CPR training in our hospital-based model using mixed quantitative and qualitative survey methods, and (3) Analyze the costs of our VSI CPR educational program, and perform a budget impact analysis comparing the two CPR strategies in Specific Aim 1 with regard to the staff opportunity costs and cost per subject with adequately retained skills as cost modeling inputs. Our investigative team is uniquely poised to accomplish this work, with its longstanding focus on clinical CPR research and track record of collaboration in CPR education. This innovative approach, to match CPR training with public need via the hospital platform and the use of VSI, may serve as a national model for dissemination of lifesaving CPR skills to a highly motivated population.

描述（由申请人提供）：迅速输送心肺复苏（CPR）将心脏骤停（SCA）的存活率增加2-3倍，但大多数旁观者实现的受害者仍然无初次尝试就死亡。我们对如何将CPR培训传播到处于危险人群的理解中存在批判性的知识差距。这很重要，因为CPR的交付代表了少数可用于改善SCA生存的工具之一，SCA每年都会损害200,000多人。患有冠状动脉疾病的个体有显着增加SCA的风险，在家庭环境中发生了超过75％的SCA事件。综上所述，这两种观察结果突出了对心血管健康的机会，通过针对患因冠状动脉疾病并发症的家庭成员（尤其是配偶）的患者（尤其是配偶）的培训来影响心血管健康。当前的CPR培训实施在很大程度上未能达到这种处于危险的人群。试图简化CPR教育，从而扩大和增加培训导致“仅动手” CPR的发展，从而忽略了对口通气的需求。但是，广泛实施的首选策略尚不清楚。我们工作的长期目标是建立“现实世界” CPR传播的最佳实践，该实践将培训场所与处于危险的人群相匹配，最大化复苏技能的保留率并促进采取行动意愿。为此，本应用程序的目的是使用最近在基于医院的实施计划中的最近经过验证的视频自我指导（VSI）CPR计划来测试两种CPR教育策略。我们的核心假设是，与标准CPR相比，在这种高度动机的AT风险人群中，仅手动的CPR培训将产生提高的技能保留率，并解决重要的训练障碍。作为一个传播项目，将向每家医院的当地利益相关者提供高度的自治权，以量身定制每个站点的员工和入学方法，一个重要的目标是从他们的实施经验中学习。为了检验我们的中心假设，我们将在八个医院队列中实现以下特定目标：（1）评估三个月后三个月的复苏技能保留的客观指标，以随机分配为手动提供仅动用的VSI CPR培训与标准VSI CPR。 （2）衡量使用混合定量和定性调查方法在我们的医院模型中注册CPR培训的障碍和动机，以及（3）分析我们的VSI CPR教育计划的成本，并进行预算影响分析，并进行预算影响分析，以比较特定目标中的两种CPR策略在特定目标中与员工的成本和每个受试者的成本保持成本为成本的成本成本模型。我们的调查团队唯一准备完成这项工作，长期以来一直关注临床CPR研究和CPR教育协作的记录。这种创新的方法是通过医院平台和使用VSI将CPR培训与公众需求相匹配，可以作为传播救生CPR技能的国家模式。