Cardiac arrest leadership: in need of resuscitation?
BACKGROUND
Leadership skills directly correlate with the quality of technical performance of cardiopulmonary resuscitation (CPR) and clinical outcomes. Despite an improved focus on non-technical skills in CPR training, the leadership of cardiac arrests is often variable.


OBJECTIVE
To assess the perceptions of leadership and team working among members of a cardiac arrest team and to evaluate future training needs.


METHODS
Cross-sectional survey of 102 members of a cardiac arrest team at an Acute Hospital Trust in the UK with 892 inpatient beds. Responses sought from doctors, nurses and healthcare assistants to 12 rated statements and 4 dichotomous questions.


RESULTS
Of 102 responses, 81 (79%) were from doctors and 21 (21%) from nurses. Among specialist registrars 90% agreed or strongly agreed that there was clear leadership at all arrests compared with between 28% and 49% of nurses and junior doctors respectively. Routine omission of key leadership tasks was reported by as many as 80% of junior doctors and 50% of nurses. Almost half of respondents reported non-adherence with Advanced Life Support (ALS) guidelines. Among junior members of the team, 36% felt confident to lead an arrest and 75% would welcome further dedicated cardiac arrest leadership training.


CONCLUSIONS
Leadership training is integrated into the ALS (Resus Council, UK) qualification. However, this paper found that in spite of this training; standards of leadership are variable. The findings suggest a pressing need for further dedicated cardiac arrest leadership training with a focus on improving key leadership tasks such as role assignment, team briefing and debriefing.
Royal Free London NHS Foundation Trust, London, UK.
Philip S
PS
Robinson
Royal Free London NHS Foundation Trust, London, UK.
Emma
E
Shall
Royal Free London NHS Foundation Trust, London, UK.
Roby
R
Rakhit
D022561:Advanced Cardiac Life Support / Q000379:methods* / Q000592:standards; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006323:Heart Arrest / Q000628:therapy*; D057209:Hospital Rapid Response Team / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D009726:Nurses; D010820:Physicians; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D006113:United Kingdom
ACCIDENT & EMERGENCY MEDICINE; CARDIOLOGY; INTENSIVE & CRITICAL CARE; MEDICAL EDUCATION & TRAINING