Cardiac arrest is a prominent cause of death for adults in the United States. Postcardiac arrest syndrome can have devastating consequences ranging from mild memory impairment to permanent neurologic deficits. Only 9.5% of out-of-hospital cardiac arrest (OHCA) patients survive to discharge. Since 2002, scientific literature has supported the use of targeted temperature management (TTM) for improved outcomes in comatose OHCA patients. There is limited use of TTM protocols for cardiac arrest survivors in clinical practice, as translation of evidence-based guidelines into clinical practice remains a complicated task. The authors' goal was to utilize the Promoting Action on Research Implementation in Health Services (PARiHS) framework prospectively to develop a TTM program for OHCA survivors in two community hospitals. A collaborative team of providers from an urban hospital and a suburban hospital joined forces to bring evidence into practice with the endpoint of initiating TTM in the emergency, cardiac catheterization, and intensive care units. TTM was successfully implemented with multiple points of access within two community hospitals. The investigative program cared for 25 OHCA patients during the first year of inception. The TTM patients who survived to discharge displayed a trend of improved neurologic outcome based on the modified Rankin scale and a slight increase in the survival to discharge rate.
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