Abstract
Background Maternal Cardio-Pulmonary Resuscitation (CPR) stands as a pivotal emergency multidisciplinary measure for resuscitating pregnant women facing cardiac or respiratory arrest.1 Effective and timely multidisciplinary maternal resuscitation can decrease maternal fatalities and improve outcomes for both mothers and newborns.2 Hamad International Training Centre not only provides official resuscitation courses, like Advanced Life Support Obstetrics and Neonatal Resuscitation Program, but also ensures the preparedness of frontline care providers in dealing with cardiac arrest events within Hamad Medical Corporation facilities through routine simulated drills and monitoring of relevant Key Performance Indicators (KPIs). This study aims to evaluate the impact of a multidisciplinary maternal resuscitation training program and the implementation of a maternal resuscitation algorithm pathway (figure 1) on seven essential KPIs: 1) time to confirm cardiac arrest, 2) code blue and/or code white activation time, 3) time to attempt the first chest compression, 4) defibrillator arrival time, 5) time to first defibrillation shock, code blue/code white arrival time, and 6) time to perform perimortem cesarean delivery.
Methods A pre-test/post-test design was employed to achieve the aim of the study. The sample included three frontline multidisciplinary maternal resuscitation teams (physicians, midwives, and nurses) who participated in both pre-test and post-test group are (N=30). The multidisciplinary resuscitation teams were observed during cardiac arrest simulated drills both before and after implementation of a multidisciplinary resuscitation simulation-based training program and the introduction of the maternal resuscitation algorithm pathway, focusing on the seven KPIs.
Results The analysis of descriptive and inferential data (table 1) revealed that four of seven KPIs (1, 2, 4, 7) showed significant improvement post-implementation of the program.
Conclusion The study concluded that the combination of multidisciplinary maternal resuscitation simulation-based training with formal resuscitation courses, alongside the introduction of a clearly defined maternal resuscitation algorithm, enhanced frontline staff preparedness in managing maternal cardiac arrest.
Maternal resuscitation algorithm pathway implemented by Hamad Medical Corporation, Doha, Qatar
References
Cobb B, Lipman S. Cardiac arrest: obstetric CPR/ACLS. Clinical Obstetrics and Gynecology 2017 Jun 1;60(2):425–30. doi: 10.1097/GRF.0000000000000273
Knapp C, Bhatia K. Maternal collapse in pregnancy. British Journal of Hospital Medicine 2022 Dec 2;83(12):1–2. DOI: 10.12968/hmed.2022.0259
Ethical Approval/IRB Statement The project obtained approval as a quality improvement initiative from the Director of Hamad International Training Center (HITC) and the Medical Education Department of Hamad Medical Corporation (HMC). Consequently, it was exempt from undergoing ethical review and obtaining Institutional Review Board approval.
Disclosures and Acknowledgments We extend our heartfelt gratitude to Mr. Abdulhakim Saif Al-Wegdi and Ms. Aseel Hatamleh for their steadfast dedication and commitment to upholding the rigor, quality, and pertinence of our study. Their combined expertise and insightful feedback have substantially strengthened the robustness of our research framework.
