Assessment of basic life support skill retention in the trained nursing staff of A Cardiac Surgery Centre
Mihali, Pigi G.
Chouliaras, Giorgos L.
Papadimitriou, Lila J.
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Background: Members of the nursing staff are the first to respond to a cardiac arrest episode occurring in a hospitalized patient. For this reason the nursing staff should receive special training in order to be able to provide high quality cardiopulmonary resuscitation (CPR) Training-acquired CPR skills and self-confidence have been observed to decline over time, which could be an important issue in planning strategies for continuing training of nursing personnel. Aim: Assessment of whether trained nurses were able to perform basic life support (BLS) sufficiently, and to what extent their skills had declined over time. It was aimed to determine the time point after which the level of skills of the nurses dropped significantly and to investigate whether this deterioration had an effect on their self-confidence. All the assessments were made according to the latest European Resuscitation Council guidelines (2005) concerning skills in BLS, with the exception of defibrillation. Method: The study participants were 103 nurses, recruited from the intensive care units, nursing wards and emergency department of the "Onassis" Cardiac Surgery Centre. The participants were classified into three groups, according to the time since their last training in BLS: group A: <6 months, group B: 6-12 months, group C: >12 months. They were asked to perform BLS on an ACLS manikin (AMBU®, Cardiac Care Trainer System, Denmark). At the end of the test they were asked to report the degree of self-confidence in performing real time BLS. The study was conducted between February 2010 and August 2010. Results: None of the three groups demonstrated adequacy in performing the algorithm of BLS. The total number of successful skills was negatively correlated with the time elapsed since the last training (p<0.01). In particular, group C, with the longest time since training, was inferior to both groups A and B (p<0.01), while the comparison between groups A and B was not statistically significant (p=0.063). When each individual skill was evaluated, safety (p<0.01), calling for help (p<0.01), clearing the airways (p<0.01), activating the emergency medical service (EMS) (p<0.01), applying the correct ratio of chest compressions/breaths (p<0.01) and following the correct sequence (p<0.01) were all negatively affected by the time since the last training. No association was found between the degree of self-confidence and the time since the last training (p=0.47). Conclusions: Skills in performing BLS acquired through special training tend to decline over time. Nurses who had been trained less than 6 months before the evaluation performed better in six individual BLS skills than those who had been trained more than 6months previously. In conclusion, repeated training courses at intervals of less than 6 months may be necessary in order for nurses to achieve improved skill retention in BLS.