Association of cardiopulmonary resuscitation psychomotor skills with knowledge and self‐efficacy in nursing students

Effective cardiopulmonary resuscitation (CPR) skills are essential for better patient survival, but whether these skills are associated with knowledge of and self‐efficacy in CPR is not well known. The purpose of this study was to assess the quality of CPR skills and identify the association of the psychomotor skills with knowledge and self‐efficacy at the time of CPR skills training. A convenience sample of 124 nursing students participated in a one‐group posttest‐only study. The quality of CPR psychomotor skills, as assessed by structured observation using a manikin, was suboptimal. Nursing students who performed correct chest compression skills reported higher self‐efficacy, but there was no association between CPR psychomotor skills and total knowledge. Rigorous skills training sessions with more objective feedback on performance and individual coaching are warranted to enable mastery learning and self‐efficacy.     

Update on recommendations for adult basic cardiopulmonary resuscitation

One of the most urgent situations faced by nurses is cardiac arrest. Knowledge of cardiopulmonary resuscitation (CPR) is essential for survival after intra-or out-of-hospital cardiac arrest. Two of the main factors predicting survival after a cardiopulmonary arrest are the immediate start of CPR and early activation of the survival chain. In 2005 The European Resuscitation Council published new recommendations on CPR. The changes center on simplification of the protocol, giving greater importance to chest compressions than to mouth-to-mouth breath resuscitation. After checking that the victim is not breathing, 30 compressions must be immediately given. The first 2 rescue breaths and carotid pulse checking have been eliminated. The current recommended ratio of chest compressions-breaths is 30:2.     

The retention of cardiopulmonary resuscitation skills

Although a great emphasis has recently been placed on training both the medical profession and the general public in cardiopulmonary resuscitation (CPR), studies have demonstrated that retention of resuscitation skills is poor. Although CPR certification is generally valid for a 1- to 2-year period, evaluation of trainees at all levels has demonstrated a marked lack of proficiency over this course of time. This paper reviews the studies that have disclosed this lack of skills retention, as well as proposed solutions and reinforcement techniques. CPR course content and certification criteria must be appropriate to maximize retention as well as learning. To this end a simplification of basic life-support training curricula is recommended.     

Cardiopulmonary resuscitation with semi-automated external defibrillator: assessment of the teaching-learning process

Studies demonstrate that, for every minute delayed on defibrillating a heart arrest patient, survival chances decrease by 10%, and that the same chances of survival are 98% effective when it is employed within 30 seconds. While attending a heart arrest patient, it is crucial that the use of external semi-automated defibrillator (AED) is included in the training. The purpose of the present study is to compare Psychomotor Ability and the Theoretical Knowledge of lay people on cardiopulmonary resuscitation (CPR) using AED, before and after training. This sample was composed of 40 administrative workers of a public institution that were trained on CPR technique using EAD, as an experiment. The significantly higher scores in the assessment instrument items of Psychomotor Ability and Theoretical Knowledge, after training, indicates that the participants have presented improvements in their performances.     

Methods of assessing cardiopulmonary resuscitation skills: a systematic review.

Valid and reliable instruments are needed for assessment and comparison of training outcomes after various methods of cardiopulmonary resuscitation training. Trials were retrieved by searching MEDLINE (1990-February 2005) and using the reference lists of original communications and reviews. Studies were considered relevant if they included an intervention, a study population of life support providers randomized and divided into groups and an evaluation or assessment of the performance. The studies were analyzed and scored to assess their validity. Twenty-five studies fulfilled the criteria. Nineteen of them assessed cardiopulmonary resuscitation skills, four cardiopulmonary resuscitation and defibrillation and two assessed defibrillation only. The mean number of participants was 107 (range 36-495). A wide variety of assessment methods were used in the studies with methodological shortcomings. Most studies in this review compared participants with each other, not against a standard or a defined passing level. Qualified studies with well defined study populations, standardized study settings and explicit, comparable outcomes would be needed to assess the quality of cardiopulmonary resuscitation and defibrillation performance.     

提高实习护生心肺复苏技能的教学方法探讨

<正>心肺复苏(cardiopulmonary resuscitation,CPR)是急诊医学的重要内容之一,及时有效的心肺复苏救治可明显提高复苏成功率并能最大程度保护脏器功能,大大降低病死率。心肺复苏术是医务人员必须掌握的急救技能之一。在临床教学中,应     

列车上适应性心肺复苏技术研究

[目的]探讨列车上适应性心肺复苏技术.[方法]按照<2005国际心肺复苏和心血管急救指南>单人操作法在陆地上进行训练,操作者准确掌握之后,在开动的列车上实施心肺复苏,对复苏的结果进行评价,找出列车上复苏失败的原因,研究改进技术方法,采用改进后的技术在开动的列车上再次进行心肺复苏,并评价正确率.[结果]采用陆地训练的技术方法,列车上实施人工呼吸和胸外按压正确率低,与陆地上实施正确率比较,差异有统计学意义(P＜0.01);改进后的心肺复苏技术在列车上实施较改进前人工呼吸和胸外心脏按压正确率显著提高(P＜0.01).[结论]特定的环境应有相适应的护理技术,改进后的心肺复苏技术能较好地适应列车上抢救需求,初步形成了列车上的心肺复苏技术方案.     

列车上适应性心肺复苏技术研究

[目的]探讨列车上适应性心肺复苏技术。[方法]按照《2005国际心肺复苏和心血管急救指南》单人操作法在陆地上进行训练,操作者准确掌握之后,在开动的列车上实施心肺复苏,对复苏的结果进行评价,找出列车上复苏失败的原因,研究改进技术方法,采用改进后的技术在开动的列车上再次进行心肺复苏,并评价正确率。[结果]采用陆地训练的技术方法,列车上实施人工呼吸和胸外按压正确率低,与陆地上实施正确率比较,差异有统计学意义（P〈0.01）;改进后的心肺复苏技术在列车上实施较改进前人工呼吸和胸外心脏按压正确率显著提高（P〈0.01）。[结论]特定的环境应有相适应的护理技术,改进后的心肺复苏技术能较好地适应列车上抢救需求,初步形成了列车上的心肺复苏技术方案。     

Cardiopulmonary resuscitation surprise drills for assessing, improving and maintaining cardiopulmonary resuscitation skills of hospital personnel.

BACKGROUND: Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel trained in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. Western Galilee Hospital has developed simulator programs for surprise CPR training exercises in all hospital departments and units. This study assessed the efficacy of surprise drills. METHODS: Advanced cardiac life-support instructors performed 131 surprise drills between 2003 and 2005, using a computerized simulation mannequin (SIM 4000). Nine criteria were measured and scored in the drill: reaction time, CPR according to ABC principles, calling for doctor, CPR knowledge, CPR skills, resuscitation management, staff work, resuscitation chart, and defibrillator management. Drills were evaluated, discussed, and compared with previous drills from the same department and from other departments. RESULTS: A gradual improvement was observed in the results of the drills held through 2003-2005, more significantly in the medical departments than in the surgical departments and outpatient clinics. The average score in 2005 was 77.2% (P=0.001), compared with 74% (P=0.012) in 2004 and 59% (P<0.001) in 2003. Major improved criteria were calling for doctor, staff work, CPR knowledge, and defibrillator (P<0.05). CONCLUSION: It is our belief that surprise resuscitation drills constitute an effective tool to improve performance in case of a real emergency resuscitation, both on a departmental and a general hospital level.     

Simultaneous sternothoracic cardiopulmonary resuscitation: a new method of cardiopulmonary resuscitation

No existing device for cardiopulmonary resuscitation (CPR) is designed to exploit both the "cardiac pump" and the "thoracic pump" effect simultaneously. The purpose of this study was to measure the haemodynamic effect of a new simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device that could compress the sternum and constrict the thoracic cavity simultaneously in a canine cardiac arrest model. After 4 min of ventricular fibrillation, 24 mongrel dogs were randomized to receive standard CPR (n=12) or SST-CPR (n=12). SST-CPR generated a new pattern of the aortic pressure curve presumed to be the result of both sternal compression and thoracic constriction. SST-CPR resulted in significantly higher mean arterial pressure than standard CPR (68.9+/-16.1 vs. 30.5+/-10.0 mmHg, P<0.01). SST-CPR generated higher coronary perfusion pressure than standard CPR (47.0+/-11.4 vs. 17.3+/-8.9 mmHg, P<0.01). End tidal CO(2) tension was also higher during SST-CPR than standard CPR (11.6+/-6.1 vs. 2.17+/-3.3 mmHg, P<0.01). In this preliminary animal model study, simultaneous sternothoracic cardiopulmonary resuscitation generated better haemodynamic effects than standard, closed chest cardiopulmonary resuscitation.     

Modified cardiopulmonary resuscitation (CPR) instruction protocols for emergency medical dispatchers: rationale and recommendations

BACKGROUND: International consensus guidelines now support the use of "chest compressions-only" cardiopulmonary resuscitation (CPR) instructions (CCOIs) by emergency medical dispatch (EMD) personnel providing telephone assistance to untrained bystanders at a cardiac arrest scene. These guidelines are based largely on evolving experimental data and a clinical trial conducted in one venue with distinct emergency medical services (EMS) system features. Accordingly, the Council of Standards for the National Academies of Emergency Dispatch was asked to adapt a modified telephone CPR protocol, and specifically one that could be applied more broadly to the spectrum of EMS systems. METHODS: A group of international EMD specialists, researchers and professional association representatives analyzed available scientific data and considered variations in EMS systems, particularly those in Europe and North America. RESULTS AND CONCLUSIONS: Several recommendations were established: (1) to avoid confusion, bystanders already providing CPR should continue those previously learned methods; (2) following a sudden collapse unlikely to be of respiratory etiology, CCOIs should be provided when the bystander is not CPR-trained, declining to perform mouth-to-mouth ventilation or unsure of actions to take; (3) following 4 min of CCOIs, ventilations can be provided, but, for now, only at a compression-ventilation ratio of 100:2 until EMS arrives; (4) until more data become available, dispatchers should follow existing compression-ventilation protocols for children and adult cases involving probable respiratory/trauma etiologies; (5) EMD CPR protocols should account for EMS system features and receive quality oversight and expert medical direction.     

感控式心肺复苏背板:按标准进行心肺复苏的裁判员

目的 发明一种感控式心肺复苏(CPR)背板,引导施救者进行标准CPR.方法 施救者将一个既具有支撑功能、又能提供标准按压参数和频率提示的多功能智能化感控式CPR背板置于患者胸背部下方,将患者的头部置于背板上方中央的凹槽中,按2005国际CPR指南进行徒手胸外心脏按压,参照背板显示窗口的标准压力及频率提示实时调整,以完成标准的胸外按压.结果 感控式CPR背板较以往用于CPR时的支撑背板具有对按压时压力和频率的显示功能,现场实施时能即时反馈客观数据,使施救者达到标准CPR的要求,从而提高了CPR的成功率;且使用感控式CPR背板进行CPR时操作的规范性明显优于传统的CPR,能有效规避不规范胸外按压引发的胸肋骨骨折等并发症.结论 感控式CPR背板在具备以往垫板支撑功能的同时,规避了传统胸外按压时的不规范操作,减少了并发症,提高了CPR的成功率,担当了提示、监督和协助施救者按标准进行CPR裁判员的重要角色.     

上海市中学生心肺复苏技能培训的效果观察

[目的]探讨中学生心肺复苏(CPR)理论知识和操作技能培训的方法、意义及效果。[方法]采用多种培训形式相结合的方法对不同年级的303名中学生进行心肺复苏理论知识和操作技能的培训,在培训前后对中学生心肺复苏理论知识和技能进行测评。[结果]303名中学生普遍缺乏心肺复苏理论知识和操作技能,通过培训,初中组和高中组急救知识考核及格率分别由0.7%和13.2%上升至79.2%和88.1%,两组培训前后得分差异有统计学意义(P<0.01);培训后初中组和高中组CPR操作技能考核的合格率分别为97.9%和100.0%,差异无统计学意义(P>0.05)。[结论]中学生普遍缺乏心肺复苏相关知识,建议尽早将CPR知识纳入教育课程。     

临床护士心肺复苏培训技能保留的研究

[目的]研究临床护士心肺复苏(CPR)技能保留情况,寻找最佳的再培训时间间隔.[方法]抽取3所三级甲等医院的内科、外科和急诊科在职临床护士162名,分别采用传统讲授练习(A组)、多媒体指导练习(B组)和自我指导练习(C组)法进行培训,测试培训前、培训后立即、培训后3个月和培训后6个月成人单人CPR操作成绩,并进行不同阶段的比较.[结果]3组培训后CPR技能保留显著提高(P＜0.01);但在培训后3个月和培训后6个月时技能保留明显下降(P＜0.01),A组、C组在培训后3个月时不能实施有效CPR,B组培训后接近6个月时不能实施有效CPR.[结论]采用传统讲授练习和自我指导练习方法对临床护士进行CPR技能培训应在培训后3个月时即开始再培训;采用多媒体指导练习方法的再培训时间不宜超过培训后6个月.     

Updating cardiopulmonary resuscitation skills: a study to examine the efficacy of self-instruction on nurses' competence

Nurses' competence in cardiopulmonary resuscitation (CPR) has been shown to be consistently poor over the past decade. Studies have suggested that CPR teaching methods need to be evaluated and refined in order to improve practice. Self-instruction has been suggested as one alternative to formal retraining programmes, but has not been evaluated with respect to nurses in the UK. A quasi-experimental design utilizing random allocation of matched subjects to one experimental and two control groups was adopted with a sample of 20 undergraduate nursing students. The subjects' CPR ability was assessed concurrently using a resuscitation manikin and an observational checklist. Subjects undertaking self-instruction produced significantly (P < 0.05) higher ability scores than those who did not participate in retraining. The time spent in self-instruction was evaluated positively by the students. The results are discussed in the light of previous research and current recommendations for regular CPR updating by all clinical nurses.