title: Cardiopulmonary resuscitation feedback improves the quality of chest compression provided by hospital health care professionals.
abstract: OBJECTIVE
  High-quality chest compressions (CCs) are an important component of successful resuscitation. Suboptimal in-hospital CC are commonly reported. Skill degradation and fatigue have been implicated. We assessed the effect of a handheld feedback device on the measured and perceived quality of CC and rescuer physiologic response.
  
  
  METHODS
  This is a nonblinded randomized controlled study of nurses at an academic medical center. Participants performed CC on a mannequin either with or without a feedback device. Compression rate (CR) and compression depth (CD), heart rate, and oxygen saturation were documented. Perceived quality of CC, fatigue, and ease of use of the device were obtained.
  
  
  RESULTS
  Twelve nurses were in the feedback group (FG) and 13 were controls. Mean CD was significantly higher in the FG (1.99 ± 0.37 in vs 1.52 ± 0.36 in; P = .005) and mean CR significantly lower in the FG (127 ± 13.8 per min vs 101 ± 9.7 per min; P ≤ .0001). Using a CD of more than 1.5 in and a CR of 90 to 100 as a composite measure of high-quality CC, the FG performed significantly better (81.4% ± 22.0% vs 10.4% ± 21.9%; P < .0001). Perceived CD, CR, and fatigue did not differ between groups; however, participants overestimated depth and underestimated rate. The FG rated the design as user-friendly (85% + 26%) helpful in maintaining correct CR (83% + 26%).
  
  
  CONCLUSIONS
  A handheld accelerometer-based audiovisual cardiopulmonary resuscitation (CPR) feedback device significantly improved the quality of CCs provided by experienced hospital nurses in a simulated setting, with no perceived or measured difference in fatigue between the 2 groups. The CPR feedback provides an effective means to monitor and improve CPR performance.
authors.affiliation: STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Charles N
authors.initials: CN
authors.lastname: Pozner
authors.forename: Adam
authors.initials: A
authors.lastname: Almozlino
authors.forename: Jonathan
authors.initials: J
authors.lastname: Elmer
authors.forename: Stephen
authors.initials: S
authors.lastname: Poole
authors.forename: De'Ann
authors.initials: D
authors.lastname: McNamara
authors.forename: David
authors.initials: D
authors.lastname: Barash
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000451:nursing; D002983:Clinical Competence; D005246:Feedback; D005260:Female; D006336:Heart Massage / Q000451:nursing / Q000592:standards*; D006801:Humans; D007318:Inservice Training; D008297:Male; D008348:Manikins