P0581 - Crash Cart Educational Intervention: A Targeted Cohort Educational Intervention with Survey

Background
While pediatric residents are educated about Pediatric Advanced Life Support (PALS), there is no formal curriculum to teach them about resuscitation equipment. Multiple pediatric residents at our institution identified discomfort with locating and using resuscitation supplies as reasons that deter their involvement in code situations.

We aimed to educate pediatric residents about the “crash cart” in order to increase their comfort and competency in code situations where there is limited personnel and ultimately improve patient outcomes.

Methods
We performed a targeted cohort educational intervention with survey. A baseline knowledge test consisting of 15 questions regarding resuscitation equipment was given to pediatric residents in July of 2019. Throughout the 2019-20 academic year, 10 small group sessions were held. During the 45-minute educational sessions, a pre-intervention survey was administered to assess residents’ self-reported confidence with resuscitations including equipment usage. The residents were subsequently instructed about equipment with the use of a crash cart. A post-intervention survey measuring self-reported confidence and the same knowledge test that was administered in July were given directly after the intervention. Additionally, a class comparison between the 2019-20 and 2020-21 residency classes will be carried out to compare the impact of the intervention on the residency program as a whole.

Results
On the initial knowledge test, less than half of the residents knew the location of the back board, AED pads, endotracheal tubes, and suction. Additionally, less than half of the residents knew the color the end-title CO2 monitor turns after successful intubation and that there are multiple concentrations of dextrose in the crash cart.

The average knowledge test score for residents was 7.5/15 in July and 14.0/15 after the intervention. The residents’ self-reported scores directly before and after intervention were as follows: “capable of running a code” from 2.2/7 to 2.9/7, “able to find equipment” from 2.2/7 to 5/7, “comfortable using equipment” from 2.5/7 to 4.3/7, “prepared to manage a resuscitation” from 2.4/7 to 3.1/7.

Further statistical analysis is currently in process and we anticipate the results will be available for poster presentation including knowledge scores between the 2019-20 and 2020-21 residency classes which will be compared.

Conclusions
Prior to this intervention, pediatric residents had significant knowledge gaps regarding resuscitation equipment. After the intervention, residents’ knowledge of resuscitation supplies increased. Additionally, residents reported improvement in their ability to find equipment in the crash cart and increased comfort using the equipment. Overall, residents felt more capable of running a code and more prepared to manage pediatric resuscitations after being trained on the crash cart in a small group setting.