(655) Enhancing Obstetric Team Readiness for Maternal Cardiac Arrest Through Simulation-Based, Longitudinal Defibrillator Education

Maternal cardiac arrest is a rare but critical emergency requiring rapid recognition and coordinated response to optimize maternal and fetal survival. Despite widespread Basic Life Support (BLS) certification, institutional preparedness varies. This quality improvement project aimed to improve obstetric team competency in defibrillator use through a structured educational intervention.

Study Design:

This was a longitudinal IRB-approved project from June 2023 to May 2025. The educational intervention included: (1) online defibrillator training; (2) hands-on skill stations covering defibrillator and code cart use; and (3) team-based simulation emphasizing high-quality CPR, defibrillator pad placement, and delivery of a shock for a shockable rhythm. Staff completed an objective BLS skills assessment, with responses scored using a 5-point Likert scale. Assessments were completed prior to initial training in 2023 and prior to annual education in 2025 to evaluate baseline knowledge and retention over time. Performance in each measure was classified as “Proficient” (scores 4–5) or “Not Proficient” (scores 1–3); proportions were compared using chi-square analysis.

Results:

Among 272 staff surveyed (58 in 2023, 214 in 2025), no significant differences were observed in assessing responsiveness, breathing, pulses; performing compressions; or providing rescue breaths (Table 1). Significant improvements occurred in defibrillator-specific skills: correct pad placement (37.9% vs. 77.1%, p < 0.001), clearing before shock (74.1% vs. 92.5%, p < 0.0001), and safe shock delivery (81.0% vs. 93.9%, p = 0.007).

Conclusion:
A structured educational intervention significantly improved staff readiness for maternal cardiac arrest and defibrillator use. Nonetheless, 22% of staff in 2025 remained unable to correctly place defibrillator pads, suggesting knowledge decay and the impact of staff turnover. These findings underscore the need for ongoing, repetitive training to maintain competency in managing high-acuity, low-frequency events such as maternal cardiac arrest.