The impact of quantitative feedback on the performance of chest compression by basic life support trained clinical staff

Abstract

Background: The quality of CPR is directly related to survival outcomes following sudden cardiac arrest but, CPR competency amongst nursing and medical staff is generally poor. The skills honed in CPR recertification training rapidly decline in quality, even as soon as eight weeks following the training. High frequency low dose training has been recommended to address this decay in skills. Automated training devices that provide feedback may be useful in conducting low dose training, which would assist hospitals to manage the often logistically difficult, and financially costly exercise of conducting training programs. Little evidence is published about the improvement in skills performance that can be derived from isolated feedback from these training devices.

Objectives: To investigate whether the feedback from an automated training device can produce performance in a 'low dose' episode of re-training on chest compressions and compression depth for CPR.

Methods: A repeated measures study was conducted assessing the compression rate and depth quality over 2min using a Laerdal QCPR® simulation manikin capable of recording performance data. On-screen feedback was provided to participants between attempts. Convenience sampling recruited undergraduate and qualified nursing and medical staff who were engaged in a CPR recertification program at a major Australian private hospital.

Results: In total, 150 participants were enrolled. Feedback from the automated training device was sufficient to produce a significant improvement in both chest compression rate (95% CI 13.3 to 19.7; p<0.001) and depth (95% CI 5.9 to 9.7; p<0.001) during the low dose training episode.

Conclusions: The feedback provided from an automated training device was sufficient to produce an improvement in performance in chest compressions in CPR. This demonstrates an alternate staff training model that could improve patient outcomes, and allow for higher frequency training whilst potentially reducing costs and the logistical problems many medical institutions face with staff training.

Keywords: CPR; Cardiac arrest; Chest compressions; Education; Nurse; Patient safety.