Comparison of an interactive CD-based and traditional instructor-led Basic Life Support skills training for nurses

Effectiveness of video self-instruction training on cardiopulmonary resuscitation retention of knowledge and skills among nurses in north-western Nigeria

Background

Adaptable cardiopulmonary resuscitation/basic life support (CPR/BLS) training are required to reduce cardiac arrest mortality globally, especially among nurses. Thus, this study aims to compared CPR knowledge and skills retention level between instructor-led (control group) and video self-instruction training (intervention group) among nurses in northwestern Nigeria.

Methods

A two-arm randomized controlled trial study using double blinding method was conducted with 150 nurses from two referral hospitals. Stratified simple random method was used to choose eligible nurses. For video self-instruction training (intervention group), participants learnt the CPR training via computer in a simulation lab for 7 days, in their own available time whereas for instructor-led training (control group), a 1-day program was conducted by AHA certified instructors. A generalized estimated equation model was used for statistical analysis.

Results

Generalized Estimated Equation showed that there were no significant differences between the intervention group (p = 0.055) and control group (p = 0.121) for both CPR knowledge and skills levels respectively, whereas higher probability of having good knowledge and skills in a post-test, one month and three-month follow-up compared to baseline respectively, adjusted with covariates (p < 0.05). Participants had a lower probability of having good skills at 6-month follow-up compared to baseline, adjusted with covariates (p = 0.003).

Conclusion

This study showed no significant differences between the two training methods, hence video self-instruction training is suggested can train more nurses in a less cost-effective manner to maximize resource utilization and quality nursing care. It is suggested to be used to improve knowledge and skills among nurses to ensure cardiac arrest patients receive excellent resuscitation care.

Initial implementation of the resuscitation quality improvement program in emergency department of a teaching hospital in China

Background

Cardiopulmonary resuscitation (CPR) skills may decay over time after conventional instructor-led BLS training. The Resuscitation Quality Improvement® (RQI®) program, unlike a conventional basic life support (BLS) course, is implemented through mastery learning and low-dose, high-frequency training strategies to improve CPR competence. We facilitated the RQI program to compare the performance of novices vs those with previous BLS training experience before RQI implementation and to obtain their confidence and attitude of the RQI program.

Methods

A single-center observational study was conducted from May 9, 2021 to June 25, 2021 in an emergency department of a tertiary hospital. The performance assessment data of both trainees with a previous training experience in conventional BLS course (BLS group) and the novice ones with no prior experience with any BLS training (Non-BLS group) was collected by RQI cart and other outcome variables were rated by online questionnaire. Outcome measurements included chest compression and ventilation in both adult-sized and infant-sized manikins.

Results

A total of 149 participants were enrolled. Among them, 103 participants were in BLS group and 46 participants in Non-BLS group. Post RQI training, all the trainees achieved a passing score of 75 or more, and obtained an improvement in CPR performance. The number of attempts to pass RQI for compression and ventilation practice was lower in the BLS group in both adult and infant training sessions (P < 0.05). Although the BLS group had a poor baseline, it had fewer trials and the same learning outcomes, and the BLS group had better self-confidence. Trainees were well adapted to the innovative training modality, and satisfaction among all of the participants was high. Only the respondents for non-instructor led training, the satisfaction was low in both groups (72.8% in BLS group vs 65.2% in No-BLS group, strongly agreed).

Conclusion

Among novices, RQI can provide excellent CPR core skills performance. But for those who had previous BLS training experience, it was able to enhance the efficiency of the skills training with less time consumption. Most trainees obtained good confidence and satisfaction with RQI program, which might be an option for the broad prevalence of BLS training in China.

Cardiopulmonary Resuscitation Training for Healthcare Professionals: A Scoping Review

SUMMARY STATEMENT

The optimal strategy for training cardiopulmonary resuscitation (CPR) for healthcare professionals remains to be determined. This scoping review aimed to describe the emerging evidence for CPR training for healthcare professionals.We screened 7605 abstracts and included 110 studies in this scoping review on CPR training for healthcare professionals. We assessed the included articles for evidence for the following topics: training duration, retraining intervals, e-learning, virtual reality/augmented reality/gamified learning, instructor-learner ratio, equipment and manikins, other aspects of contextual learning content, feedback devices, and feedback/debriefing. We found emerging evidence supporting the use of low-dose, high-frequency training with e-learning to achieve knowledge, feedback devices to perform high-quality chest compressions, and in situ team simulations with debriefings to improve the performance of provider teams.

Comparison of a virtual reality compression-only Cardiopulmonary Resuscitation (CPR) course to the traditional course with content validation of the VR course - A randomized control pilot study

Introduction

Technology has been a major contributor to recent changes in education, where simulation plays a huge role by providing a unique safe environment, especially with the recent incorporation of immersive virtual reality (VR) training. Cardiopulmonary Resuscitation (CPR) is said to double, even triple survival from cardiac arrest, and hence it is crucial to ensure optimal acquisition and retention of these skills. In this study, we aim to compare a VR CPR teaching program to current teaching methods with content validation of the VR course.

Methods

A randomized single-blinded simulation-based pilot study where 26 participants underwent baseline assessment of their CPR skills using a validated checklist and Laerdal QCPR®. Participants were randomly allocated and underwent their respective courses. This was followed by a final assessment and a questionnaire for content validation, knowledge and confidence. The data was analysed using STATA 16.2 to determine the standardized mean difference using paired and unpaired t-test.

Results

Subjective assessment using the checklist showed statistically significant improvement in the overall scores of both groups (traditional group mean improved from 6.92 to 9.61 p-value 0.0005, VR group from 6.61 to 8.53 p-value 0.0016). However, no statistically significant difference was noted between the final scores in both the subjective and objective assessments. As for the questionnaire, knowledge and confidence seemed to improve equally. Finally, the content validation showed statistically significant improvement in ease of use (mean score 3 to 4.23 p-value of 0.0144), while for content, positivity of experience, usefulness and appropriateness participants showed similar satisfaction before and after use.

Conclusion

This pilot study suggests that VR teaching could deliver CPR skills in an attractive manner, with no inferiority in acquisition of these skills compared to traditional methods. To corroborate these findings, we suggest a follow-up study with a larger sample size after adding ventilation and Automated External Defibrillator (AED) skills to the VR course with re-examination after 3–6 months to test retention of the skills.

Health beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study

OBJECTIVE

To evaluate the effect of an educational intervention on health beliefs and adherence of elderly people to fall prevention measures.

METHODS

This is a quasi-experimental study, carried out at the Senior Citizens' Center. Sixty-eight elderly completed the intervention. The intervention consisted of four meetings focused on beliefs about falls and prevention, and the evaluation occurred at baseline and 30 days after completion.

RESULTS

The elderly were predominantly women (83.82%), with one to four years of schooling (36.76%), with health problems (95.59%), and 48.53% had fallen. There was a significant increase in perceived susceptibility, severity, benefits, barriers, and total health belief score post educational intervention. By adding total to partial adherence, there was a significant increase in the adherence of the elderly to fall prevention measures after the educational intervention.

CONCLUSION

Educational intervention was able to improve the beliefs and adherence of the elderly to fall prevention measures.

Comparison of Long-Term Effects between Chest Compression-Only CPR Training and Conventional CPR Training on CPR Skills among Police Officers

Despite of the changes of out-of-hospital cardiac arrest (OHCA) survival rise when bystander CPR is provided, this was only conducted in about 23% of OHCA patients in Korea in 2018. Police officers acting as first responders have a high chance of witnessing situations requiring CPR. We investigated long-term effects on CPR quality between chest compression-only CPR training and conventional CPR training in police officers to find an efficient CPR training method in a prospective, randomized, controlled trial. Police officers underwent randomization and received different CPR training. With the Brayden Pro application, we compared the accuracy of CPR skills immediately after training and the one after 3 months. Right after training, the conventional CPR group presented the accuracy of the CPR skills (compression rate: 74.6%, compression depth: 66.0%, recoil: 78.0%, compression position: 96.1%) and chest compression-only CPR group presented the accuracy of the CPR skills (compression rate: 74.5%, compression depth: 71.6%, recoil: 79.2%, compression position: 99.0%). Overall, both groups showed the good quality of CPR skills and had no meaningful difference right after the training. However, three months after training, overall accuracy of CPR skills decreased, a significant difference between two groups was observed for compression position (conventional CPR: 80.0%, chest compression only CPR: 95.0%). In multiple linear regression analysis, three months after CPR training, chest compression-only CPR training made CPR skills accuracy 28.5% higher. In conclusion, police officers showed good-quality CPR right after CPR training in both groups. But three months later, chest compression-only CPR training group had better retention of CPR skills. Therefore, chest compression-only CPR training is better to be a standard training method for police officers as first responders.

Basic Life Support Training for undergraduate nursing students: An integrative review

The aim of this review was to identify the role of basic life support training interventions in international undergraduate nursing education, that support optimal acquisition and retention of knowledge, psychomotor skills and resuscitation self-efficacy. Twenty-four articles were identified and analysed using an integrative review approach. Studies were reviewed for quality using a Critical Appraisal Skills Programme checklist. Common objective and standardised methods of basic life support education practice were identified: instructor led, simulation experiences, self-directed learning, skills training combined with clinical practicum, and computer-based training. Evaluation of competency was collected primarily from multiple-choice questionnaires or researcher-designed checklists, with a lack of objective performance data noted. Importantly, current teaching approaches do not guarantee acquisition or retention of basic life support skills. Objective feedback from technologies supporting cardiopulmonary resuscitation training may be useful in acquisition and retention of psychomotor skills, and therefore requires further exploration. Development of robust, psychometrically sound instruments are needed to accurately and consistently measure nursing students' skills performance.

Simulación de la capacitación en emergencias para estudiantes de enfermería

Introducción: La capacitación de los estudiantes de enfermería en maniobras de reanimación cardiopulmonar (RCP) es esencial para un desempeño seguro y de calidad en diferentes escenarios de desempeño de enfermería. La integración a los escenarios de práctica clínica, desde los primeros años del programa, proporciona una mayor seguridad para actuar en situaciones de emergencia. El objetivo era evaluar los conocimientos de los estudiantes de enfermería recién graduados antes y después de realizar una capacitación sobre soporte vital básico (SVB) mediante simulación. Materiales y métodos: Se trata de un estudio cuasiexperimental llevado a cabo en 2015 en una institución pública de educación superior en el sureste de Brasil. Los estudiantes respondieron una prueba previa y, justo después de la intervención, respondieron otra prueba posterior. Para el análisis, se utilizaron las pruebas emparejadas de McNemar y Wilcoxon. Resultados: Se identificó que inmediatamente después de tomar el curso, los estudiantes mostraron tener conocimientos satisfactorios  (≥ 80%) en varios temas. Sin embargo, las preguntas de la prueba relacionadas con los eslabones de la cadena de supervivencia (-18.7%; p = 0.004) y con la secuencia de la maniobra de apertura de vía aérea (-16.0%; p = 0.091) mostraron una reducción del número de respuestas correctas después de la intervención. Discusión: El uso de estrategias combinadas, incluida la simulación de fidelidad media para la enseñanza de SVB, ha facilitado la comprensión del contenido de SVB. Conclusiones: El uso de la simulación mostró una evolución positiva del conocimiento sobre los temas relacionados con la profundidad de la compresión torácica, la secuencia de la RCP y la relación compresión-ventilación por minuto en la RCP. Como citar este articulo: Costa, Christefany Régia Braz; Melo, Elizabete Santos; Reis, Renata Karina. Simulação no ensino de emergência para estudantes de enfermagem. Revista Cuidarte. 2020; 11(2): e853. http://dx.doi.org/10.15649/cuidarte.853

Baseline Cardiopulmonary Resuscitation Skill Performance of Nursing Students Is Improved After One Resuscitation Quality Improvement Skill Refresher

This article reports the results of baseline cardiopulmonary resuscitation (CPR) skills performance measurements from 467 nursing students. All participants had completed a CPR course. Baseline measurements were compared to performance after one 10-minute refresher training session on the Resuscitation Quality Improvement system. Significant improvements were made after the computer- and practice-based refresher. Findings suggest that staff developers should evaluate the use of audio and visual feedback devices to improve the quality of CPR provided by clinical staff.

Comparing two teaching methods based on concept map and lecture on the level of learning in basic life support

Education and training about Basic Life Support is necessary for different medical groups such as nurses. Different teaching methods have been developed to preserve essential medical information, knowledge and skills. The purpose of the study was to determine the effect of concept map-based and lecture-based teaching methods on the level of nursing students' learning in Basic Life Support. This quasi-experimental study was conducted in 2015 on 57 nursing students from a nursing school in Tehran. Students were selected by census and then divided into lecture (n = 29) and concept map groups (n = 28) by random allocation. The effect of education on knowledge (before, immediately after, one week after and one month after session) and practice (before and immediately after session) was studied. No significant differences were found between the mean scores of knowledge and practice before intervention (P > 0.05). After intervention the mean scores of knowledge were not statistically significant between the two groups (P > 0.05) but mean scores of practice were significantly higher in the concept map group (P = 0.03). In achieving skill and practice goals, it seems that the concept map-based teaching method was more effective than the lecture method.

Self-learning training versus instructor-led training for basic life support: A cluster randomised trial

AIM

To compare the effectiveness of two basic life support (BLS) training interventions.

METHODS

This experimental trial enrolled 1301 lay people in BLS training. The participants were cluster randomised to either self-learning training or to traditional instructor-led training. Both groups used the Mini-Anne Kit (Laerdal Medical, Stavanger, Norway) and standardised film instructions. After training, the participants practical skills were measured on a Resusci Anne manikin and an AED trainer with the PC SkillReporting system (Laerdal Medical, Stavanger, Norway). The primary outcome was the total score from the modified Cardiff Test of basic life support with automated external defibrillation (19-70 points), six months after training. The secondary outcomes were total score directly after training and quality of individual variables, self-assessed knowledge, confidence and willingness to act, directly and six months after training.

RESULTS

For primary outcome six months after training there was no statistically significant difference (p = 0.44) between the total score for the self-learning group (n = 670; median 59, IQR 55-62) compared with the instructor-led group (n = 561; median 59, IQR 55-63). The instructor-led training resulted in a statistically significant higher total score (median 61 versus 59, p < 0.0001), self-assessed knowledge and willingness to act, directly after training (secondary outcomes) compared with the self-learning training.

CONCLUSIONS

There was no statistically significant difference in practical skills or willingness to act when comparing self-learning training with instructor-led training six months after training in BLS. However, directly after the intervention, practical skills were better when the training was led by an instructor.

Basic Life Support Training Methods for Health Science Students: A Systematic Review

The acquisition of competencies in basic life support (BLS) among university students of health sciences requires specific and updated training; therefore, the aim of this review was to identify, evaluate, and synthesise the available scientific knowledge on the effect of training in cardiorespiratory resuscitation in this population. A comprehensive literature search was conducted in MEDLINE, CUIDEN, Web of Science, Wiley Online Library, CINAHL, and Cochrane, including all randomised clinical trials published in the last ten years that evaluated basic life support training methods among these students. We selected a total of 11 randomissed clinical trials that met the inclusion criteria. Participants were nursing and medicine students who received theoretical and practical training in basic life support. The studies showed a great heterogeneity in training methods and evaluators, as did the feedback devices used in the practical evaluations and in the measurement of quality of cardiorespiratory resuscitation. In spite of the variety of information resulting from the training methods in basic life support, we conclude that mannequins with voice-guided feedback proved to be more effective than the other resources analysed for learning.

Acquisition of Knowledge and Practical Skills after a Brief Course of BLS-AED in First-Year Students in Nursing and Physiotherapy at a Spanish University

Out-of-hospital cardiorespiratory arrest is one of the leading causes of death in the Western world. Early assistance with quality Cardiopulmonary Resuscitation (CPR) and the use of a defibrillator may increase the percentage of survival after this process. The objective of this study was to evaluate the effect of CPR training and the management of an Automatic External Defibrillator (AED). A descriptive, cross-sectional, observational study was carried out among students in the first year of a Nursing and Physiotherapy degree of the University of León. To achieve this goal, a theoretical-practical educational intervention of four hours’ duration which included training on CPR, AED and Basic Life Support (BLS) was carried out. A total of 112 students were included. The results showed an increase in theoretical knowledge on BLS as well as on CPR and AED, and practical skills in CPR and AED management. A theoretical exposition of fifteen minutes and the practical training of CPR wasenough for the students to acquire the necessary theoretical knowledge, although the participants failed to reach quality criteria in CPR. Only 35.6% of students reached the right depth in compressions. Also, ventilation was not performed properly. Based on the results, we cannot determine that the percentage of overall quality of CPR was appropriate, since 57.6% was obtained in this respect and experts establish a value higher than 70% for quality CPR. There was a clear relationship between sex, weight, height and body max index (BMI), and quality CPR performance, being determinant variables to achieve quality parameters. Currently, Basic Life Support training in most universities is based on training methods similar to those used in the action described. The results obtained suggest implementing other training methods that favour the acquisition of quality CPR skills.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses

CONTEXT

Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training.

AIMS

To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses.

SETTING AND DESIGN

Tertiary care hospital, Prospective, repeated-measures design.

SUBJECTS AND METHODS

A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses.

STATISTICAL ANALYSIS USED

SPSS for Windows version 21.0.

RESULTS

The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140).

CONCLUSIONS

Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.