• Elizabeth A Hunt, Mary E Mancini, Melinda Smyth, Tanya Lane Truitt, and NRCPR Investigators.
• Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ehunt@jhmi.edu
• Jt Comm J Qual Patient Saf. 2009 Jan 1; 35 (1): 13-20.

BackgroundData suggest that the overall quality of inhospital resuscitation is suboptimal and contributes to poor patient outcomes. In 2000 the American Heart Association created the National Registry of Cardiopulmonary Resuscitation (NRCPR) as an evidence-based hospital safety program. Participating hospitals voluntarily join the registry and pay an annual fee that includes data support and report generation. The primary purpose of NRCPR is to support local facility efforts in practice management and performance improvement (PI).Chain Of SurvivalThe Chain of Survival illustrates the series of critical, interdependent actions necessary to maximize patient outcome from sudden cardiac arrest--early access to the emergency response system, early cardiopulmonary resuscitation (CPR), early defibrillation, and early advanced cardiovascular care. NRCPR specifically addresses each link and helps hospitals develop, implement, and monitor their resuscitation processes in a manner that builds on available evidence.Participation In NrcprOn enrollment into NRCPR, each hospital identifies an onsite coordinator who is instructed on a standardized method for abstracting data from patient charts and how to enter data into the NRCPR database. The NRCPR database is managed centrally and provides participating organizations with ongoing, quarterly, and annual reports related to their resuscitation events.DiscussionNRCPR is used as both a local PI tool as well as a source of data that scientists are analyzing to further the understanding of inhospital resuscitation processes and outcomes. Over time, researchers have recognized the need to refine the Chain of Survival to reflect the unique aspects of inhospital resuscitation. A rapid response system provides a new link at the beginning, and postresuscitation care provides a new link at the end of the Chain of Survival.

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