The association of recent simulation training and clinical experience of team leaders with cardiopulmonary resuscitation quality during in-hospital cardiac arrest

Objective: We aimed to investigate the association of recent team leader simulation training (<6 months) and years of clinical experience (>= 4 years) with chest compression quality during in -hospital cardiac arrest (IHCA). Methods: This cohort study of IHCA in four Danish hospitals included cases with data on chest compression quality and team leader characteristics. We assessed the impact of recent simulation training and experienced team leaders on longest chest compression pause duration (primary outcome), chest compression fraction (CCF), and chest compression rates within guideline recommendations using mixed effects models. Results: Of 157 included resuscitation attempts, 45% had a team leader who recently participated in simulation training and 66% had an experienced team leader. The median team leader experience was 7 years [Q1; Q3: 4; 11]. The median duration of the longest chest compression pause was 16 s [10; 30]. Having a team leader with recent simulation training was associated with significantly shorter longest pause durations (difference: -7.11 s (95% -CI: -12.0; -2.2), p = 0.004), a higher CCF (difference: 3% (95% -CI: 2.0; 4.0%), p < 0.001) and with less guideline compliant chest compression rates (odds ratio: 0.4 (95% -CI: 0.19; 0.84), p = 0.02). Having an experienced team leader was not associated with longest pause duration (difference: -1.57 s (95% -CI: -5.34; 2.21), p = 0.42), CCF (difference: 0.7% (95% -CI: -0.3; 1.7), p = 0.17) or chest compression rates within guideline recommendations (odds ratio: 1.55 (95% -CI: 0.91; 2.66), p = 0.11). Conclusion: Recent simulation training of team leaders, but not years of team leader experience, was associated with shorter chest compression pauses during IHCA.