Effect of Prior Cardiopulmonary Resuscitation Knowledge on Compression Performance by Hospital Providers

Abstract

IntroductionThe purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest.MethodsThis cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin.ResultsData from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ≥100 performed compressions at a significantly higher rate than participants identifying <100 (μ=117 vs. 94, p<0.001). Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p<0.01). No significant differences were found in depth or recoil performance based on knowledge of guidelines.ConclusionKnowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.

Cardiopulmonary resuscitation by Emergency Medical Services in South Africa: Barriers to achieving high quality performance

“…Despite these theoretical components having a significant effect on their respective skill components, results remained dismal. Correct compression rate was also correlated to knowledge which supports prior findings [35] , however only 8% achieved this.…”

“…There is a paucity of research studying the relationship between theoretical knowledge and psychomotor skills of CPR. To our knowledge, the only studies similar to this are of emergency medical technicians in the pre-hospital setting [29] , and hospital staff and medical students in the hospital setting [35] . These results were similar in that knowledge of the guidelines had a significant effect on some components of CPR performance, but overall knowledge and skill remain poor.…”

“…These results were similar in that knowledge of the guidelines had a significant effect on some components of CPR performance, but overall knowledge and skill remain poor. Brown showed knowledge components that affected skill were rate and compression to ventilation ratio, whilst Burkhardt similarly showed knowledge to have an effect on rate and hand placement [29] , [35] . Our study showed additional components where knowledge had a significant effect on skill.…”

Factors associated with knowledge and attitude towards adult cardiopulmonary resuscitation among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: an institutional-based cross-sectional study

“…Also, poor-quality CPR has been shown to have similar outcomes to patients receiving no CPR. 32 In the current study, the knowledge level of health professionals towards adult CPR was 25.1% (95% CI 21.2 to 29.3). The finding is lower compared with other studies done in Kuwait (36%), 16 Jamaica (46%), 17 Pakistan (44.85%) 26 and Nigeria (36.9%).…”

A comparison of commercially available compression feedback devices in novice and experienced healthcare practitioners: A prospective randomized simulation study

“…In accordance with prior medical simulations studies, subjects were further categorized as novice vs experienced providers. Novice providers were defined as having been trained in basic life support (BLS) but never performed CPR clinically (Buléon et al, ; Kurowski et al, ; Papalexopoulou et al, ; Skorning et al, ), whereas experienced providers had performed CPR clinically (Burkhardt, Glick, & Terndrup, ; Truszewski et al, ). Similar to prior investigations, a separate test of BLS proficiency (beyond certification) was not required (Fischer, Neuhold, et al, ).…”