Abstract Sun905: Improving Time to First Defibrillation in In-Hospital Cardiac Arrests Through a Multidisciplinary, Simulation-Based Intervention

Abstract

Background: Timely defibrillation is critical for survival in patients experiencing in-hospital cardiac arrest with shockable rhythms. Despite this, delays remain common in complex care settings. This quality improvement initiative sought to reduce defibrillation times by fostering leadership across all levels of staff and enhancing team coordination during Code Blue events. Objective: To implement and evaluate a multidisciplinary intervention—including staff education, simulation training, and workflow enhancements—with the goal of reducing the time to first defibrillation to two minutes or less, consistent with Get With The Guidelines–Resuscitation (GWTG-R) recommendations. Methods: Conducted in a complex care facility, the initiative employed a multifaceted approach involving bedside nurses, providers, ancillary departments, and leadership teams. Interventions included: Simulation of the first five minutes of Code Blue events Hands-on defibrillator training and pad placement Standardized communication protocols Increased interdisciplinary participation in Code Blue Committee meetings Empowerment of direct care nurses to assume early leadership roles Data were collected over two periods: pre-intervention (March–August 2023, 11 months) and post-intervention (September 2023–October 2024, 13 months). Analysis included only arrests with initial shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia). Results: The average time to first defibrillation decreased from 6.75 minutes pre-intervention to 2.76 minutes post-intervention, representing a 59.1% reduction. Prior to the intervention, times reached up to 15 minutes. In the final three months post-intervention, all defibrillations occurred within three minutes of arrest. Conclusion: A structured, simulation-based, and multidisciplinary intervention significantly improved time to defibrillation in in-hospital cardiac arrests. These findings support broader adoption of similar models to improve resuscitation outcomes and align with national performance benchmarks.