ECC Quality Assurance & Improvement 2 — Questions and Answers
Question 1: Which metric is most directly used to evaluate the effectiveness of a resuscitation team's performance in a cardiac arrest event?
- Time to first defibrillation (Correct answer)
- Number of staff present
- Patient's age at arrest
- Length of shift before the event
Correct answer: Time to first defibrillation
Time to first defibrillation is a key performance indicator directly linked to survival outcomes in cardiac arrest.
Question 2: A hospital notices its CPR compression depth is consistently below 2 inches on quality recordings. What is the BEST immediate QI action?
- Retrain staff on compression technique using CPR feedback devices (Correct answer)
- Purchase new defibrillators
- Increase the number of staff per arrest team
- Change the resuscitation protocol completely
Correct answer: Retrain staff on compression technique using CPR feedback devices
Targeted retraining with real-time CPR feedback devices directly addresses the identified compression depth deficiency.
Question 3: What does the term 'chest compression fraction' (CCF) represent in cardiac arrest QI programs?
- Proportion of arrest time with active chest compressions (Correct answer)
- Force applied per compression
- Number of compressions per minute
- Ratio of compressions to ventilations
Correct answer: Proportion of arrest time with active chest compressions
Chest compression fraction measures the proportion of total cardiac arrest time during which chest compressions are being performed.
Question 4: During a post-arrest debriefing, the team discovers the first rhythm check was delayed by 3 minutes. Which QI framework step does this debriefing represent?
- Identify and analyze the problem (Correct answer)
- Implement the solution
- Sustain the improvement
- Define the project scope
Correct answer: Identify and analyze the problem
Debriefing to uncover performance gaps is part of identifying and analyzing problems within a QI cycle.
Question 5: A cardiac arrest quality dashboard shows a drop in ROSC rates over the past quarter. Which next step aligns with evidence-based QI practice?
- Conduct a root cause analysis to identify contributing factors (Correct answer)
- Immediately discipline the resuscitation team leaders
- Suspend resuscitation training until rates improve
- Increase medication doses used during arrest
Correct answer: Conduct a root cause analysis to identify contributing factors
Root cause analysis systematically identifies underlying factors contributing to decreased ROSC rates before corrective action is taken.
Question 6: Which CPR quality metric has the strongest evidence for correlation with improved survival to hospital discharge?
- Minimizing peri-shock pauses to less than 10 seconds (Correct answer)
- Performing CPR for at least 60 minutes
- Achieving a compression rate above 120/min
- Delivering ventilations every 3 seconds
Correct answer: Minimizing peri-shock pauses to less than 10 seconds
Minimizing peri-shock pauses (pre/post-shock) to under 10 seconds preserves coronary perfusion and is strongly linked to improved survival.
Question 7: An ECC quality program implements a 'pit crew' resuscitation model. What is the PRIMARY QI benefit of this approach?
- Pre-assigned roles reduce task confusion and compression interruptions (Correct answer)
- It reduces the need for defibrillation
- Fewer medications are required during resuscitation
- It eliminates the need for post-event debriefs
Correct answer: Pre-assigned roles reduce task confusion and compression interruptions
Pre-assigned roles in a pit crew model minimize confusion, task overlap, and compression interruptions during resuscitation.
ECC Quality Assurance & Improvement 2
Which metric is most directly used to evaluate the effectiveness of a resuscitation team's performance in a cardiac arrest event?