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Article Critique: Training interval in cardiopulmonary resuscitation Brittany Spence, BSN, RN, CEN - Carilion Roanoke Memorial Hospital Emergency Department
Article Review of: Oermann, M.H., Krusmark, M.A., Kardong-Edgren, S., Jastrzembski, T.S., & Gluck, K.A. (2020). Training interval in cardiopulmonary resuscitation, PLoS ONE, 15(1), e0226786. https://doi.org/10.1371/journal.pone.0226786 Cardiac arrests can occur unexpectedly in any type of setting, and having providers that are competent with Basic Life Support (BLS) is especially important in the healthcare setting. This article describes a research study that compares four different cardiopulmonary resuscitation (CPR) retraining intervals for nursing students for best impact on high quality compressions and ventilations. The study was conducted with first year prelicensure nursing students who were re-certified in the same BLS option by the American Heart Association or the American Red Cross. The study was approved by The Institutional Review Boards (IRBs) from 4 universities, while the remaining schools participated through a collaborative agreement with Duke University. A sample of 475 students from 10 United States schools of nursing were randomly selected for this study. Students were then randomly assigned to different CPR training intervals: 101 nurses were selected for daily training, 116 for weekly training, 108 for monthly training, and 150 for quarterly training. The rationale for these groupings was not described, although this would have been helpful to understand the methodology. Laerdal Resusci Anne QCPR adult manikins were used for CPR training within a Resuscitation Quality Improvement (RQI) mobile simulation station, and outcomes were measured by compression and ventilation quality defined by the RQI program (Oermann et al., 2020). A strength of this study was the use of the same standardized manikin with feedback technology and the same quality scale for each student, ensuring that all feedback obtained was measured consistently. Using a percentage scale of 0-100%, seven scores were obtained for each student: overall compression score, percentage of compressions with adequate depth, rate, release, volume, correct hand placement and overall ventilation score. The data collected from the students in each area were analyzed using the R statistical software. Regardless of the specific training interval, each area showed improvements from the beginning to the end of the study. All of the students were tested in the compression categories with their previous BLS certification, and all students scored under 75% before further training. After the last training session, students in all training increments showed improvements. The combined compression areas of scoring showed a mean improvement ranging from 80.6% - 90%, the most improvement being in those that were trained daily. The combined ventilation areas of scoring showed a mean of 18.4% prior to more frequent training, and the mean improvement percentage ranged from 68.1% - 88.1%, the most improvement also being in those that were trained daily. It was noted that the lowest area of improvement was shown in those that had the least frequent – quarterly - training. An improvement to 80.6% was noted for quarterly trained students in combined compression areas, and an improvement to 68.1% was noted for quarterly trained students in combined ventilation areas. Receiving daily training resulted in the most favorable outcomes in this study, meaning that more frequent practice of CPR showed improved results.
