TRAINING PROGRAMME FOR HIGH-PERFORMANCE RESUSCITATION TEAMS IN THE IN-HOSPITAL SETTING
DOI:
https://doi.org/10.63176/mk3few60Keywords:
Cardiopulmonary Resuscitation, Simulation Training, Education Continuing, Clinical Competence, Critical CareAbstract
Introduction: Maintaining Advanced Life Support competencies requires recurrent, context-specific training and organisational support.
Objectives: To describe the development, structure, implementation plan and monitoring plan of a training programme for physicians and nurses working in an in-hospital medical emergency team.
Methods: This article describes the development of a training intervention prior to implementation. Reporting was organised using GUIDED, and the intervention was described according to TIDieR. The need was identified from the absence of regular training, findings from local research and informal feedback; programme development also considered available evidence and national regulations.
Results: The development process resulted in a programme comprising four continuous quality improvement projects introduced progressively and maintained cumulatively: training in a controlled simulated environment, in situ simulation in the intensive care unit, simulation in other hospital departments, and self-directed training with self-assessment. Monitoring includes five indicators: programme delivery, participation, completion of essential components, simulated performance, and implementation of improvement actions.
Conclusions: The programme provides a cumulative structure for regular training in technical and non-technical ALS competencies. Monitoring implementation should support feasibility assessment and guide adjustments; the defined indicators do not allow clinical effects to be inferred.
References
1. Berg KM, Bray JE, Djärv T, Drennan IR, Greif R, Liley HG, et al. Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations. Circulation. 21 de outubro de 2025;152(16_suppl_1). doi:10.1161/CIR.0000000000001361 DOI: https://doi.org/10.1161/CIR.0000000000001366
2. Cheng A, Lauridsen K, Greif R, Finn J, Eastwood K, Yeung J, et al. Uniform Reporting of Outcomes From Resuscitation Education Research: The Resuscitation Education Utstein Style: A Consensus Report From the International Liaison Committee on Resuscitation. Circ Popul Health Outcomes. 20 de abril de 2026;19(5);e000144. doi:10.1161/HCQ.0000000000000144 DOI: https://doi.org/10.1161/HCQ.0000000000000144
3. Farquharson B, Cortegiani A, Lauridsen KG, Yeung J, Greif R, Nabecker S. Teaching team competencies within resuscitation training: A systematic review. Resusc Plus. setembro de 2024;19:100687. doi:10.1016/j.resplu.2024.100687 DOI: https://doi.org/10.1016/j.resplu.2024.100687
4. Ferreira-Sousa S, Silva-Poeira A, Silva-Amaral G. Advanced Cardiovascular Life Support simulated practice in nursing: A prospective cohort study. Enferm Intensiva Engl Ed. outubro de 2025;36(4):500567. doi:10.1016/j.enfie.2025.500567 DOI: https://doi.org/10.1016/j.enfie.2025.500567
5. Fulton II MR, Nordquist E. Advanced Cardiac Life Support (ACLS). Em: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 [citado 6 de maio de 2026]. Disponível em: http://www.ncbi.nlm.nih.gov/books/NBK613285/ PubMed PMID: 40198051.
6. Kuzovlev A, Monsieurs KG, Gilfoyle E, Finn J, Greif R, Bigham BL, et al. The effect of team and leadership training of advanced life support providers on patient outcomes: A systematic review. Resuscitation. março de 2021;160:126–39. doi:10.1016/j.resuscitation.2021.01.020 DOI: https://doi.org/10.1016/j.resuscitation.2021.01.020
7. Al Jadidi H, Al Jufaili M. Effectiveness of a Short Refresher Course on the Retention of Cardiopulmonary Resuscitation-Related Psychomotor Skills (REF-CPR). Oman Med J. 31 de maio de 2023;38(3):e509. doi:10.5001/omj.2023.80 DOI: https://doi.org/10.5001/omj.2023.80
8. Andersson U, Boysen GN, Sterner A. Simulation-based education as a provider of fieldwork insights – experiences of ambulance nurse specialist students. BMC Nurs. 19 de dezembro de 2023;22(1):485. doi:10.1186/s12912-023-01666-2 DOI: https://doi.org/10.1186/s12912-023-01666-2
9. Nabecker S, De Raad T, Abelairas-Gomez C, Breckwoldt J, Chakroun-Walha O, Farquharson B, et al. European Resuscitation Council Guidelines 2025 Education for Resuscitation. Resuscitation. outubro de 2025;215:110739. doi:10.1016/j.resuscitation.2025.110739 DOI: https://doi.org/10.1016/j.resuscitation.2025.110739
10. Nolan JP, Sandroni C, Cariou A, Cronberg T, D’Arrigo S, Haywood K, et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2025 Post-Resuscitation Care. Resuscitation. outubro de 2025;215:110809. doi:10.1016/j.resuscitation.2025.110809 DOI: https://doi.org/10.1016/j.resuscitation.2025.110809
11. Soar J, Böttiger BW, Carli P, Jiménez FC, Cimpoesu D, Cole G, et al. European Resuscitation Council Guidelines 2025 Adult Advanced Life Support. Resuscitation. outubro de 2025;215:110769. doi:10.1016/j.resuscitation.2025.110769 DOI: https://doi.org/10.1016/j.resuscitation.2025.110769
12. Anderson R, Sebaldt A, Lin Y, Cheng A. Optimal training frequency for acquisition and retention of high-quality CPR skills: A randomized trial. Resuscitation. fevereiro de 2019;135:153–61. doi:10.1016/j.resuscitation.2018.10.033 DOI: https://doi.org/10.1016/j.resuscitation.2018.10.033
13. Au K, Lam D, Garg N, Chau A, Dzwonek A, Walker B, et al. Improving skills retention after advanced structured resuscitation training: A systematic review of randomized controlled trials. Resuscitation. maio de 2019;138:284–96. doi:10.1016/j.resuscitation.2019.03.031 DOI: https://doi.org/10.1016/j.resuscitation.2019.03.031
14. Di Fronzo P, Gaetti G, Marcassa D, Gervasi V, Dardour O, Pedretti A, et al. The Impact of ACLS Training in the Management of Cardiac Arrest: A Narrative Review. Epidemiologia. 6 de outubro de 2025;6(4):61. doi:10.3390/epidemiologia6040061 DOI: https://doi.org/10.3390/epidemiologia6040061
15. Greif R, Bhanji F, Bigham BL, Bray J, Breckwoldt J, Cheng A, et al. Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 20 de outubro de 2020;142(16_suppl_1). doi:10.1161/CIR.0000000000000896 DOI: https://doi.org/10.1161/CIR.0000000000000903
16. Peltonen V, Peltonen LM, Salanterä S, Hoppu S, Elomaa J, Pappila T, et al. An observational study of technical and non-technical skills in advanced life support in the clinical setting. Resuscitation. agosto de 2020;153:162–8. doi:10.1016/j.resuscitation.2020.06.010 DOI: https://doi.org/10.1016/j.resuscitation.2020.06.010
17. De Sousa SF, Marques MDCMP, Da Silva Amaral GMM. Factors Influencing the Maintenance of Advanced Life Support Competencies Among Critical Care Professionals: A Scoping Review. Nurs Crit Care. julho de 2026;31(4):e70545. doi:10.1111/nicc.70545 DOI: https://doi.org/10.1111/nicc.70545
18. Nallamothu BK, Greif R, Anderson T, Atiq H, Couto TB, Considine J, et al. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes. Circ Cardiovasc Qual Outcomes. novembro de 2023;16(11): e010491. doi:10.1161/CIRCOUTCOMES.123.010491 DOI: https://doi.org/10.1161/CIRCOUTCOMES.123.010491
19. Direcção-Geral da Saúde. Criação e Implementação de uma Equipa de Emergência Médica Intra-hospitalar (EEMI) [Circular Normativa] [Internet]. 2010. Disponível em: https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/circular-normativa-n-15dqsdqco-de-22062010.aspx
20. Duncan E, O’Cathain A, Rousseau N, Croot L, Sworn K, Turner KM, et al. Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study. BMJ Open. abril de 2020;10(4):e033516. doi:10.1136/bmjopen-2019-033516 DOI: https://doi.org/10.1136/bmjopen-2019-033516
21. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 7 de março de 2014;348:g1687. doi:10.1136/bmj.g1687 DOI: https://doi.org/10.1136/bmj.g1687
22. Anderson TM, Secrest K, Krein SL, Schildhouse R, Guetterman TC, Harrod M, et al. Best Practices for Education and Training of Resuscitation Teams for In-Hospital Cardiac Arrest. Circ Cardiovasc Qual Outcomes. dezembro de 2021;14(12):e008587. doi:10.1161/CIRCOUTCOMES.121.008587 DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.008587
Downloads
Published
Data Availability Statement
No data were collected or analysed for this manuscript. All relevant information supporting the results of the intervention development process is included in the article.
Issue
Section
Categories
License
Copyright (c) 2026 Sonia Sousa (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain copyright over the articles published in the Critical Patient Journal. The articles are published under Open Access licenses, licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0), which permits the use, distribution, reproduction, and adaptation of the content, provided that proper authorship is attributed and the original source is indicated.
Deprecated: Implicit conversion from float-string "155.3000" to int loses precision in /var/www/vhosts/spedc.pt/revistadoentecritico.spedc.pt/plugins/generic/pflPlugin/PflPlugin.php on line 134
