Optimizing Team-Based Interventions to Reduce Pediatric Cardiac Arrest

Tuesday, March 24, 2026

11:15 AM - 12:15 PM Central Time

Location: Connections Central - RST 18

Karen Weaver, MSN, RN, CCRN

Christus Children's Hospital, Texas

Disclosure(s): No relevant financial relationship(s) to disclose.
DM

Denise Masterson, MSN, RN, CCRN

Coordinator of Cardiac and Quality for Pediatric Critical Care Services VPS Site Coordinator, AACN
Christus Childrens Hospital, Texas

Disclosure information not submitted.
KH

Kirstin Henley, MD MSc

Assistant Professor of Pediatrics, Critical Care
Baylor College of Medicine

Disclosure information not submitted.
NB

Niveditha Balakumar, MD

Assistant Professor of Pediatrics, Critical Care
Baylor College of Medicine, Texas

Disclosure information not submitted.
DM

Daria Marshall, RN, BSN, CCRN, CPN

Nursing Director, PIMC
Christus Childrens Hospital, Texas

Disclosure information not submitted.
EK

Erica Kenyon, RN, BSN, CCRN

Nursing Manager and intermediate care unit director
Christus Childrens Hospital, Texas

Disclosure information not submitted.
KB

Keely Bogart, RN, BSN, CCRN, APHON

Nursing Management
Christus Childrens Hospital, Texas

Disclosure information not submitted.
AC

Arjun Chandran, MD

Assistant Professor of Pediatrics, Critical Care
Baylor College of Medicine, Texas

Disclosure information not submitted.

Introduction: Failure to recognize and treat clinical deterioration remains a significant source of preventable harm in the Pediatric Intensive Care Unit (PICU). Pediatric in-hospital cardiac arrest (IHCA) significantly increases mortality, with up to 50% of patients not surviving to discharge post-arrest. Early detection of clinical triggers and improved situational awareness can reduce cardiac arrest (CA) events. CHRISTUS Children's Hospital initiated a Cardiac Arrest Prevention (CAP) program to reduce IHCA incidence and improve patient outcomes.

Methods: This is a single center quality improvement project with a primary outcome of reducing the CA rates in our PICU by 25% in 18 months through the implementation of a CAP program. Based on patient data and previous studies, a CAP screening tool was developed to proactively identify patients at high risk of having CA. Identified patients triggered team huddles where shared mental models, vital sign parameters and mitigation strategies were discussed. The CA rates and duration of CPR were measured before and after the CAP implementation. During the study period there were no significant changes in our patient population or PICU census.

Results: Our historical data showed 50 CA events in a three-year period. The average length of CPR was 12:29 minutes. 118 unique CAP patients were enrolled. There were 13 total CA events in 18 months, of which 2 were enrolled in CAP. The CA rate decreased by 41.4%, from 7.56 to 4.43. The duration of CPR decreased to 7:46 minutes, a 37.8% improvement. Staff surveys showed that over 85% of providers and nurses reporting improved interprofessional collaboration, while 92% noted enhanced shared mental models. The successful implementation of the project in a combined PICU/CICU confirms findings from pediatric CICUs which have successfully implemented the CAP project.

Conclusions: The implementation of a CAP program allowing the bedside team to create a shared mental model demonstrated reduction of CA rate with decreased duration of CPR, and improved teamwork and utilization of resources.