# SAMURAI PICU: Situation Awareness incorporating Multidisciplinary Teams Reduce Arrests In the Pediatric ICU

> **NIH AHRQ R18** · CINCINNATI CHILDRENS HOSP MED CTR · 2024 · $391,666

## Abstract

PROJECT SUMMARY
Pediatric in-hospital cardiac arrest occurs almost exclusively in pediatric intensive care units and
affects thousands of hospitalized children each year. While cardiac arrest survival outcomes have
improved, more than half of these children will die prior to discharge making prevention the best
approach to improve pediatric patient safety. In our single center prior work, the use of the
SAMURAI PICU (Situation Awareness incorporating MUltidisciplinary Teams Reduce Arrests In
the PICU) bundle improved early identification of high-risk patients, increased shared situation
awareness, and supported risk mitigation plans leading to a >50% decrease in IHCA events
requiring cardiopulmonary resuscitation. Using an innovative process of emphasizing shared
situation awareness through automated clinical decision support and mitigation of risk, we will use
a user-centered design approach to adapt, implement, and assess the feasibility and
effectiveness of SAMURAI PICU at other pediatric institutions. We hypothesize that identification
of PICU patients at high risk for in-hospital cardiac arrest through the use of our automated clinical
decision support tool and integration of this high-risk status in daily safety huddles will lead to
improved shared situation awareness and subsequent reduction in cardiac arrest events. We will
utilize a five-center pragmatic prospective Hybrid Type 1 effectiveness-implementation study
leveraging the existing infrastructure of Pediatric Resuscitation Quality Collaborative to evaluate
the following specific aims: 1) adapt the SAMURAI PICU bundle at each intervention site to fit
local context through a user-centered design approach, 2) implement the SAMURAI PICU bundle
in a hybrid stepped wedge fashion and evaluate the effectiveness of the bundle to reduce CPR
events in the PICU. This proposed research is significant it has the potential to inform and
transform the field of cardiac arrest prevention and ultimately prevent death related to in hospital
cardiac arrest for thousands of children in the future significantly improving pediatric patient
safety.

## Key facts

- **NIH application ID:** 10932232
- **Project number:** 5R18HS029630-02
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Maya L Dewan
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $391,666
- **Award type:** 5
- **Project period:** 2023-09-30 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932232

## Citation

> US National Institutes of Health, RePORTER application 10932232, SAMURAI PICU: Situation Awareness incorporating Multidisciplinary Teams Reduce Arrests In the Pediatric ICU (5R18HS029630-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10932232. Licensed CC0.

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