Introduction:
Healthcare providers (HP) resuscitation team training will highly influence in-hospital cardiac arrest (IHCA) outcome. ALS courses don´t meet the need of HP to train specificities of their working context – team members’ roles and competences, human and technological available resources and space, communication with other HP.

Aim:
Our aim was to verify if low-dose high-frequency training increases team efficiency at IHCA.

Methods: 
This is an observational study in which teams of doctors and nurses of Intensive Care Unit were evaluated during the simulation of IHCA. A semiannual 2-hour training program was developed from May-2012 to Nov-2013, which enabled the elements for the manipulation of the airway adjuncts, crash-car and the defibrillator monitor. We´ve standardized a team approach model with 5 members. A record sheet was used for team evaluation during simulations. After 1st training (F1), 3 simulations were carried out in order to promote teamwork and technological competences. The 4th simulation (F4) was evaluated to assess team's performance in relation to leadership and management, equipment handling and guidelines adherence.

Results 
We’ve conducted 112 simulations at F1 and F4, 24 were excluded due to incorrect data record.
Team evaluation at F4 showed a significant gain throughout training. Real-time recording growth 75% (F1=25% VS F4=100%). The following results are a combination of several tasks: leadership and management of the team growth 40.35% (F1=42.5% VS F4=82.85%); equipment handling growth 14.29% (F1=42.85% VS F4=57.14%); adherence to the resuscitation guidelines growth 13.07% (F1=60% VS F4=73.03%).

Conclusion: 
Low-dose high-frequency not certified and immersive team training allows improvement of essential points at IHCA management and to define strategies to reduce time of action, increase coordination and ultimately augment team efficiency. This project is widespread to all clinical wards since 2014, unfortunately there´s no data to relate it to IHCA outcome.

2 - TeamECR - Treino da Equipa na Emergência Cardiorrespiratória: a Portuguese in-hospital low-dose high-frequency training program.