Hospitals in pursuit of excellence

Applying ACLS and Pregnancy Modifications to Maternal Cardiac Arrest: A Team-based Approach

Maternal cardiac arrest is rare but often fatal. Obstetricians and perinatal nurses are often first responders with limited experience in managing primary cardiac arrest and ACLS pregnancy modifications. Multidisciplinary simulations improve performance in catastrophe management but few studies regarding MCA simulation education exist. The medical center's objective was to improve retention of ACLS pregnancy-based modifications by demonstrating the skill set in a multidisciplinary simulation scenario after completing didactic computer-based training. Labor and delivery personnel (n=161) completed training. All participants completed a pre- and post-test for the CBT to evaluate material retention. Pre- and post-test scores were then compared. Video-recorded simulation scenarios were then completed in multidisciplinary teams of six to nine over a two month period. Debriefings occurred after the first scenario, allowing teams to implement video reviewed techniques in a second video recorded scenario. To assess learner improvement, times to key cardiac arrest response events (AED pad application, c-section incision, infant delivery) were compared before and after scenario debriefings.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state.  These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)