Managerial challenges in establishing a structured cardiopulmonary resuscitation program in a small health-care setup

Abstract

Introduction: Effective cardiopulmonary resuscitation (CPR) program is required in all health care organizations (HCOs). The focus is primarily on technical aspect of CPR training and managerial challenges encountered in establishment of CPR program are not discussed in detail previously. The aim was to study the managerial challenges in establishing a structured CPR program in a small HCO. A prospective, observational study conducted over a period of 3 months. All staff of the HCO was trained in basic life support. Materials and Methods: A CPR committee was constituted which formulated the CPR policy, CPR rapid response teams (CPR RRT), and training protocols and recorded observations during the study period. Statistical Analysis Used: Mean, percentage, and gain score were used for statistical analysis. Results: The major challenges encountered were unorganized work, lack of resources, old building structure with difficult to access areas, lack of knowledge upgradation, and nonmotivated staff. The clinical staff, involved in regular CPRs, although had basic CPR knowledge, they required continual refresher training. The nonclinical staff showed much larger improvement in scores post training. Conclusions: Flexible functional CPR policy with multidisciplinary CPR RRTs, low dose high frequency training, customized crash kits, interdepartmental liasoning, and mock drills were found useful in making “CPR a reflex manoeuvre” and effective implementation of CPR program. Concepts and principles implemented from organizational behavior, leadership, and motivation such as “Herzbergs Motivational hygiene theory” were useful. Continual training of staff is required for consistent delivery of high quality CPR and even nonmedical staff can be trained to provide high quality Basic Life Support (BLS) similar to clinical staff.