Impact of structured basic life-support course on nurses' cardiopulmonary resuscitation knowledge and skills: Experience of a paediatric department in low-resource country

Christian Umuhoza, Lei Chen, Juliette Unyuzumutima, Natalie McCall, Christian Umuhoza, Lei Chen, Juliette Unyuzumutima, Natalie McCall

Abstract

Introduction: The study aimed to assess the impact of a modified paediatric basic life support (BLS) training on paediatric nurses' knowledge and skills in the main tertiary level public hospital in Rwanda.

Methods: A prospective, before-and-after educational intervention study was performed. Nurses working in the paediatric department at Centre Hospitalier Universitaire de Kigali (CHUK) were enrolled after consenting to the study. A modified BLS training was administered using didactic lectures, videos, case discussions, and simulations. Knowledge and skills were assessed before, immediately and six months after the training, using the American Heart Association (AHA) multiple-choice questions test and simulation scenarios. Ethical approval from the hospital's investigational review board was obtained before the start of the study.

Results: Fifty-seven nurses working in paediatric department were included in the study, most with advanced nursing degrees. At baseline, only 3.5% scored above 80% on the knowledge test and none were able to perform high-quality one-rescuer CPR. Knowledge and high-quality one-rescuer CPR skills improved significantly immediately after the training, with 63.2% scoring above 80% and 63.2% capable of performing high-quality one-rescuer CPR (p < 0.01). Six months later, only 45.6% scored above 80% and 15.8% were capable of performing high-quality one-rescuer CPR (p < 0.01). Some skills, such as delivering breaths using bag-mask device, showed better retention.

Conclusion: In the paediatric department of the main public tertiary care hospital in Rwanda, nurses' baseline knowledge and skills in providing BLS was poor but can increase with focused BLS training. Due to the decline in knowledge and skills over six months, the use of debriefing and focused trainings following resuscitation events and improved implementation of yearly departmental refresher courses are recommended.

Keywords: Basic life support (BLS); Cardiopulmonary resuscitation (CPR); Developing countries; Education; Low-resource.

Conflict of interest statement

The principal investigator is also employed by CHUK. The authors declared no further conflict of interest.

© 2018 Published by Elsevier Ltd. CC BY 4.0.

Figures

Fig. 1
Fig. 1
Knowledge acquisition.

References

    1. Kirigia J.M., Muthuri R.D.K., Nabyonga-Orem J., Kirigia D.G. Counting the cost of child mortality in the World Health Organization African region. BMC Public Health. 2015;15:1103. doi: 10.1186/s12889-015-2465-z.
    1. Ministry of Health . 2013. National community health strategic plan.
    1. Wallace S.K., Abella B.S., Becker L.B. Quantifying the effect of cardiopulmonary resuscitation quality on cardiac arrest outcome: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2013;6:148–156. doi: 10.1161/CIRCOUTCOMES.111.000041.
    1. de Almeida A.O., Araújo I.E.M., Dalri M.C.B., Araujo S. Theoretical knowledge of nurses working in non-hospital urgent and emergency care units concerning cardiopulmonary arrest and resuscitation. Rev Lat Am Enfermagem. 2011;19:261–268.
    1. Sodhi K., Shrivastava A., Singla M. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital. Indian J Crit Care Med. 2011;15:209. doi: 10.4103/0972-5229.92070.
    1. Pareek M., Parmar V., Badheka J., Lodh N. Study of the impact of training of registered nurses in cardiopulmonary resuscitation in a tertiary care centre on patient mortality. Indian J Anaesth. 2018;62:381–384. doi: 10.4103/ija.IJA_17_18.
    1. Heng W.J.K., Seow E., Tham K.Y. Life support course for nurses in Singapore. Singapore Med J. 2011;52:557–559.
    1. Heng K.W.J., Fong M.K., Wee F.C., Anantharaman V. The role of nurses in the resuscitation of in-hospital cardiac arrests. Singapore Med J. 2011;52:611–615.
    1. Preusch M.R., Bea F., Roggenbach J., Katus H.A., Jünger J., Nikendei C. Resuscitation Guidelines 2005: does experienced nursing staff need training and how effective is it? Am J Emerg Med. 2010;28:477–484. doi: 10.1016/j.ajem.2009.01.040.
    1. Sankar J., Vijayakanthi N., Sankar M.J., Dubey N. Knowledge and skill retention of in-service versus preservice nursing professionals following an informal training program in pediatric cardiopulmonary resuscitation: a repeated-measures quasiexperimental study. Biomed Res Int. 2013;2013:1–7. doi: 10.1155/2013/403415.
    1. Yang C.-W., Yen Z.-S., McGowan J.E., Chen H.C., Chiang W.-C., Mancini M.E. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers. Resuscitation. 2012;83:1055–1060. doi: 10.1016/j.resuscitation.2012.02.027.
    1. Oermann M.H., Kardong-Edgren S.E., Odom-Maryon T. Competence in CPR. Am J Nurs. 2012;112:43–46. doi: 10.1097/01.NAJ.0000414320.71954.34.
    1. Bradley S.M. Update in cardiopulmonary resuscitation. Minerva Cardioangiol. 2011;59:239–253. doi: 10.3329/kyamcj.v9i1.36594.
    1. Cunningham L.M., Mattu A., O’Connor R.E., Brady W.J. Cardiopulmonary resuscitation for cardiac arrest: the importance of uninterrupted chest compressions in cardiac arrest resuscitation. Am J Emerg Med. 2012;30:1630–1638. doi: 10.1016/j.ajem.2012.02.015.
    1. Nishiyama C., Iwami T., Murakami Y., Kitamura T., Okamoto Y., Marukawa S. Effectiveness of simplified 15-min refresher BLS training program: a randomized controlled trial. Resuscitation. 2015;90:56–60. doi: 10.1016/j.resuscitation.2015.02.015.
    1. Nyirasafari R., Corden M.H., Karambizi A.C., Kabayiza J.C., Makuza J.D., Wong R. Predictors of mortality in a paediatric intensive care unit in Kigali, Rwanda. Paediatr Int Child Health. 2017;37:109–115. doi: 10.1080/20469047.2016.1250031.
    1. American Heart Association . 2010. 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
    1. American Heart Association . 2016. Infant CPR skills testing checklist.
    1. Ristagno G., Gullo A., Tang W., Weil M.H. New cardiopulmonary resuscitation guidelines 2005: importance of uninterrupted chest compression. Crit Care Clin. 2006;22:531–538. doi: 10.1016/j.ccc.2006.03.011.
    1. Bhatnagar V., Tandon U., Jinjil K., Dwivedi D., Kiran S., Verma R. Cardiopulmonary resuscitation: evaluation of knowledge, efficacy, and retention in young doctors joining postgraduation program. Anesth Essays Res. 2017;11:842–846. doi: 10.4103/aer.AER_239_16.
    1. Azazy H., Abdelazez A.L., Elsaie O.A. Effect of cardiopulmonary resuscitation training program on nurses knowledge and practice. Life Sci J. 2012;9:3494–3503.
    1. Heng K.W.J., Fong M.K., Wee F.C., Anantharaman V. The role of nurses in the resuscitation of in-hospital ardiac arrests. Singapore Med J. 2011;52:611–615.
    1. McInnes A.D., Sutton R.M., Orioles A., Nishisaki A., Niles D., Abella B.S. The first quantitative report of ventilation rate during in-hospital resuscitation of older children and adolescents. Resuscitation. 2011;82:1025–1029. doi: 10.1016/j.resuscitation.2011.03.020.
    1. Passali C., Pantazopoulos I., Dontas I., Patsaki A., Barouxis D., Troupis G. Evaluation of nurses’ and doctors’ knowledge of basic &amp; advanced life support resuscitation guidelines. Nurse Educ Pract. 2011;11:365–369. doi: 10.1016/j.nepr.2011.03.010.
    1. Hamilton R. Nurses’ knowledge and skill retention following cardiopulmonary resuscitation training: a review of the literature. J Adv Nurs. 2005;51:288–297. doi: 10.1111/j.1365-2648.2005.03491.x.
    1. Zhou X.L., Wang J., Jin X.Q., Zhao Y., Liu R.L., Jiang C. Quality retention of chest compression after repetitive practices with or without feedback devices: a randomized manikin study. Am J Emerg Med. 2020;38:73–78. doi: 10.1016/j.ajem.2019.04.025.
    1. Rajeswaran L., Cox M., Moeng S., Tsima B.M. Assessment of nurses’ cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana. African J Prim Heal Care Fam Med. 2018;10:e1–e6. doi: 10.4102/phcfm.v10i1.1633.
    1. Shahrakivahed A., Masinaienezhad N., Shahdadi H., Arbabisarjou A., Asadibidmeshki E., Heydari M. The effect of CPR workshop on the nurses’ level of knowledge and skill. Int Arch Med. 2015;8 doi: 10.3823/1707.
    1. Kipsang J., Bruce J.C. A comparison of cardiopulmonary resuscitation competence betwen two groups of advanced practice student nurses at a medical training colege in Kenya. Afr J Nurs Midwifery. 2011;13:103–118.
    1. Wesson H.K., Plant V., Helou M., Wharton K., Fray D., Haynes J. Piloting a pediatric trauma course in Western Jamaica: lessons learned and future directions. J Pediatr Surg. 2017;52:1173–1176. doi: 10.1016/j.jpedsurg.2017.01.003.

Source: PubMed

3
구독하다