ECC Quality Assurance & Improvement 3 — Questions and Answers
Question 1: In ECC QI programs, what does 'no-flow time' refer to?
- Duration with no chest compressions during cardiac arrest (Correct answer)
- Time before the arrest was recognized
- Interval between defibrillation attempts
- Period of post-arrest care without monitoring
Correct answer: Duration with no chest compressions during cardiac arrest
No-flow time is the total duration during a cardiac arrest when chest compressions are not being delivered, which worsens outcomes.
Question 2: Which approach best supports a culture of continuous improvement in an ECC program?
- Structured, non-punitive debriefing after every resuscitation event (Correct answer)
- Annual mandatory CPR recertification only
- Reporting poor performers to hospital administration
- Eliminating simulation training to reduce costs
Correct answer: Structured, non-punitive debriefing after every resuscitation event
Non-punitive debriefing after each event encourages honest reflection and team learning without fear of blame.
Question 3: A QI team discovers that ACLS-trained nurses are frequently unsure which compression rate to use. According to current AHA guidelines, what is the target rate?
- 100–120 compressions per minute (Correct answer)
- 60–80 compressions per minute
- 120–140 compressions per minute
- 80–100 compressions per minute
Correct answer: 100–120 compressions per minute
The AHA recommends a compression rate of 100–120 per minute for high-quality CPR in adult patients.
Question 4: When reviewing resuscitation data, which finding would MOST concern a QI coordinator focused on ventilation quality?
- Average ventilation rate of 22 breaths per minute during CPR (Correct answer)
- Tidal volume delivered via bag-mask at 500 mL
- Two-breath pause lasting under 10 seconds
- Ventilation synchronized with compressions in an intubated patient
Correct answer: Average ventilation rate of 22 breaths per minute during CPR
Hyperventilation (>10 breaths/min) during CPR increases intrathoracic pressure, reduces venous return, and worsens survival outcomes.
Question 5: A hospital's QI data shows that epinephrine administration during cardiac arrest is frequently delayed beyond 5 minutes. What system-level change would BEST address this?
- Embedding a designated medication nurse role in the resuscitation team (Correct answer)
- Increasing epinephrine stock on the unit
- Training only physicians to administer epinephrine
- Reducing epinephrine to an optional medication
Correct answer: Embedding a designated medication nurse role in the resuscitation team
Assigning a dedicated medication nurse within the team structure eliminates confusion and reduces delays in drug delivery during arrest.
Question 6: Which PDSA cycle phase involves testing a small-scale change in resuscitation practice before hospital-wide implementation?
- Do (Correct answer)
- Plan
- Study
- Act
Correct answer: Do
The 'Do' phase of a PDSA cycle is when the planned change is tested on a small scale to gather initial data.
Question 7: What role does simulation play in ECC quality assurance programs?
- It allows teams to practice and identify performance gaps in a safe environment (Correct answer)
- It replaces the need for real resuscitation debriefs
- It is used primarily for new employee orientation only
- It eliminates the need for real-time CPR feedback devices
Correct answer: It allows teams to practice and identify performance gaps in a safe environment
Simulation provides a risk-free environment to rehearse resuscitation scenarios and expose system or skill deficiencies before real events.
ECC Quality Assurance & Improvement 3
In ECC QI programs, what does 'no-flow time' refer to?