“The Use of Real-Time CPR Quality Feedback Prompts During In-Hospital Cardiac Arrest in Medical Intensive Care: Uptake and Barriers, A Single-Center Cross-Sectional Study”

Introduction High-quality cardiopulmonary resuscitation (CPR) improves survival after in-hospital cardiac arrest (IHCA). Real-time audio and visual CPR quality feedback may improve CPR quality, but real-world use and uptake are incompletely understood. We evaluated awareness, use, and barriers to defibrillator-integrated CPR feedback among Medical Intensive Care Unit (MICU) clinicians. Methods We used a cross-sectional study design. An anonymous REDCap survey was distributed to nurses, advanced practice providers (APPs), and physicians across three adult MICUs at a single urban academic medical center in February 2024. Respondents reported usual IHCA roles (chest compressor, code leader, CPR coach), familiarity with the Zoll R Series defibrillator’s visual and audio feedback functions, use of feedback during real IHCA events, and role-specific perceived barriers. Results Seventy-nine clinicians responded of the 413 invited, 54% by nurses and 43% by physicians. 94% reported involvement in an IHCA during the past year and 92% had received defibrillator training. Awareness of visual and audio feedback functions was 57% and 72%, respectively. Among those aware, 10% often or always looked at the screen for visual feedback while performing chest compressions, 37% while leading a code, and 57% as CPR coach. Audio feedback use was higher 46%, 58%, 50%. Reported barriers during IHCA events included screen placement, reliance on others to monitor visual feedback, and difficulty hearing auditory feedback. Conclusions In this single-center survey, uptake of integrated CPR feedback during IHCA was incomplete despite near-universal training, and barriers varied by role during IHCA.