We asked Jackie a few questions about her experience of participating in NCAA.
We joined NCAA in December 2014. Previously, our cardiac arrest audit form was based on the Utstein style. Compliance with filling in and returning the audit forms was quite low and it was always a challenge to get meaningful data.
In 2014, the Resuscitation Department made the decision to commit to capturing 100% of its cardiac arrests, even though this meant going out most days and collecting the data ourselves. However, there was no point in collecting data and not reporting on it; NCAA seemed the natural choice.
What do you find are the benefits of participating in NCAA for you and your hospital?
With our very first NCAA Report we were no longer “in the dark”; not only could we see our rate of in-hospital cardiac arrests but also how we compared nationally. This was one of the catalysts for a dedicated group of healthcare professionals to be able to take this data and demonstrate the need for improvement. Since then, reducing cardiac arrests and caring for patients at risk of deterioration have remained a priority, with a focus on five elements – use of electronic early warning systems, having a “Scottish structured response”, anticipatory care planning, appropriate use of DNACPRs and a case review of all cardiac arrests. Our cardiac arrest rate has fallen significantly and year on year we see improvement.
Who do you share your NCAA reports with and how?
We share our reports internally with groups such as the Resuscitation Committee, Quality Improvement Services, the Clinical Effectiveness Department, Senior Nurses and the Medical Director.
Currently, we are only one of two hospitals in Scotland that participate in NCAA. However, the Scottish Resuscitation Group (SRG) meets regularly to provide education, network and share good practice. We have presented our findings at one of the SRG meetings.
Have you had any data collection and/or validation challenges?
Occasionally, it is not always so easy to identify what time CPR was stopped as it may not be documented. Usually the length of the time the patient was resuscitated is inferred from the notes, but working out statements like "ROSC was achieved after 3 cycles" can be difficult; do they mean 3 cycles of 30:2 or 3 cycles of 2 minutes?
Do you have any tips for other NCAA participants?
Yes, have a go at the NCAA Dataset Quiz (available via File Exchange); the number of “orange flags” I used to get has dramatically reduced.
We’d like to take this opportunity to thank Jackie and Victoria Hospital, Fife, for agreeing to be interviewed and for their ongoing participation.
If you're a participating NCAA hospital and would be interested in being interviewed, please contact the NCAA Team.