Training interval in cardiopulmonary resuscitation


Autoři: Marilyn H. Oermann aff001;  Michael A. Krusmark aff002;  Suzan Kardong-Edgren aff003;  Tiffany S. Jastrzembski aff004;  Kevin A. Gluck aff004
Působiště autorů: School of Nursing, Duke University, Durham, North Carolina, United States of America aff001;  L3 Technologies at the Air Force Research Laboratory, Wright-Patterson Air Force Base, Wright-Patterson AFB, Ohio, United States of America aff002;  Center for Medical Simulation, Boston, Massachusetts, United States of America aff003;  711 Human Performance Wing, Airman Systems Directorate, Air Force Research Laboratory, Wright-Patterson Air Force Base, Wright-Patterson AFB, Ohio, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226786

Souhrn

Aim

Although evidence supports brief, frequent CPR training, optimal training intervals have not been established. The purpose of this study was to compare nursing students’ CPR skills (compressions and ventilations) with 4 different spaced training intervals: daily, weekly, monthly, and quarterly, each for 4 times in a row.

Methods

Participants were nursing students (n = 475) in the first year of their prelicensure program in 10 schools of nursing across the United States. They were randomly assigned into the 4 training intervals in each of the schools. Students were trained in CPR on a Laerdal Resusci Anne adult manikin on the Resuscitation Quality Improvement (RQI) mobile simulation station. The outcome measures were quality of compressions and ventilations as measured by the RQI program.

Results

Although students were all certified in Basic Life Support prior to the study, they were not able to adequately perform compressions and ventilations at pretest. Overall compression scores improved from sessions 1 to 4 in all training intervals (all p < .001), but shorter intervals (daily training) resulted in larger increases in compression scores by session 4. There were similar findings for ventilation skills, but at session 4, both daily and weekly intervals led to better skill performance.

Conclusion

For students and other novices learning to perform CPR, the opportunity to train on consecutive days or weeks may be beneficial: if learners are aware of specific errors in performance, it may be easier for them to correct performance and refine skills when there is less time in between practice sessions.

Klíčová slova:

Compression – Health care providers – Health services research – Human learning – Nurses – Nursing science – Resuscitation – Schools


Zdroje

1. Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, et al. Resuscitation education science: educational strategies to improve outcomes from cardiac arrest: a scientific statement from the American Heart Association. Circulation. 2018;138(6):e82–e122. Epub 2018/06/23. doi: 10.1161/CIR.0000000000000583 29930020.

2. Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J, et al. Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation. 2009;120(13):1241–7. Epub 2009/09/16. doi: 10.1161/CIRCULATIONAHA.109.852202 19752324.

3. Idris AH, Guffey D, Pepe PE, Brown SP, Brooks SC, Callaway CW, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med. 2015;43(4):840–8. Epub 2015/01/08. doi: 10.1097/CCM.0000000000000824 25565457.

4. Larribau R, Deham H, Niquille M, Sarasin FP. Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines. PLoS One. 2018;13(9):e0204169. Epub 2018/09/25. doi: 10.1371/journal.pone.0204169 30248116.

5. Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128(4):417–35. Epub 2013/06/27. doi: 10.1161/CIR.0b013e31829d8654 23801105.

6. Talikowska M, Tohira H, Finn J. Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis. Resuscitation. 2015;96:66–77. Epub 2015/08/08. doi: 10.1016/j.resuscitation.2015.07.036 26247143.

7. Wolfe H, Zebuhr C, Topjian AA, Nishisaki A, Niles DE, Meaney PA, et al. Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes. Crit Care Med. 2014;42(7):1688–95. Epub 2014/04/11. doi: 10.1097/CCM.0000000000000327 24717462.

8. Anderson R, Sebaldt A, Lin Y, Cheng A. Optimal training frequency for acquisition and retention of high-quality CPR skills: a randomized trial. Resuscitation. 2018;135:153–61. Epub 2018/11/06. doi: 10.1016/j.resuscitation.2018.10.033 30391370.

9. Cheng A, Brown LL, Duff JP, Davidson J, Overly F, Tofil NM, et al. Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial. JAMA pediatrics. 2015;169(2):137–44. Epub 2014/12/23. doi: 10.1001/jamapediatrics.2014.2616 25531167.

10. Sutton RM, Wolfe H, Nishisaki A, Leffelman J, Niles D, Meaney PA, et al. Pushing harder, pushing faster, minimizing interruptions… but falling short of 2010 cardiopulmonary resuscitation targets during in-hospital pediatric and adolescent resuscitation. Resuscitation. 2013;84(12):1680–4. Epub 2013/08/21. doi: 10.1016/j.resuscitation.2013.07.029 23954664.

11. Kleinman ME, Perkins GD, Bhanji F, Billi JE, Bray JE, Callaway CW, et al. ILCOR scientific knowledge gaps and clinical research priorities for cardiopulmonary resuscitation and emergency cardiovascular care: A consensus statement. Circulation. 2018;137(22):e802–e19. Epub 2018/04/28. doi: 10.1161/CIR.0000000000000561 29700123.

12. Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, et al. Part 14: Education: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S561–73. Epub 2015/10/17. doi: 10.1161/CIR.0000000000000268 26473002.

13. Greif R, Lockey AS, Conaghan P, Lippert A, De Vries W, Monsieurs KG. European Resuscitation Council Guidelines for Resuscitation 2015: Section 10. Education and implementation of resuscitation. Resuscitation. 2015;95:288–301. Epub 2015/10/20. doi: 10.1016/j.resuscitation.2015.07.032 26477418.

14. Kardong-Edgren S, Oermann MH, Odom-Maryon T. Findings from a nursing student CPR study: implications for staff development educators. J Nurses Staff Dev. 2012;28(1):9–15. Epub 2012/01/21. doi: 10.1097/NND.0b013e318240a6ad 22261900.

15. Oermann MH, Kardong-Edgren SE, Odom-Maryon T. Effects of monthly practice on nursing students’ CPR psychomotor skill performance. Resuscitation. 2011;82(4):447–53. Epub 2011/01/14. doi: 10.1016/j.resuscitation.2010.11.022 21227563.

16. Saad R, Sampaio Favarato MH, Ferreira de Paiva E, do Patrocinio Tenorio Nunes M. Medical student skill retention after cardiopulmonary resuscitation training: a cross-sectional simulation study. Simulation in healthcare: journal of the Society for Simulation in Healthcare. 2019. Epub 2019/10/28. doi: 10.1097/sih.0000000000000383 31652179.

17. Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, et al. Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers. Pediatrics. 2011;128(1):e145–51. Epub 2011/06/08. doi: 10.1542/peds.2010-2105 21646262.

18. Niles DE, Nishisaki A, Sutton RM, Elci OU, Meaney PA, O’Connor KA, et al. Improved retention of chest compression psychomotor skills with brief "rolling refresher" training. Simulation in healthcare: journal of the Society for Simulation in Healthcare. 2017;12(4):213–9. Epub 2017/04/04. doi: 10.1097/SIH.0000000000000228 28368963.

19. Lin Y, Cheng A, Grant VJ, Currie GR, Hecker KG. Improving CPR quality with distributed practice and real-time feedback in pediatric healthcare providers—a randomized controlled trial. Resuscitation. 2018;130:6–12. Epub 2018/06/27. doi: 10.1016/j.resuscitation.2018.06.025 29944894.

20. Kyllonen P. Training assessment. In: Tobias S, Fletch JD, editors. Training and retraining: a handbook for business, industry, government, and the military New York: Macmillan; 2000. p. 525–49.

21. Shute VJ. Focus on formative feedback. Review of Educational Research. 2008;78(1):153–89.

22. Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, et al. Part 12: Education, implementation, and teams: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122(16 Suppl 2):S539–81. Epub 2010/10/22. doi: 10.1161/CIRCULATIONAHA.110.971143 20956260.

23. Yeung J, Meeks R, Edelson D, Gao F, Soar J, Perkins GD. The use of CPR feedback/prompt devices during training and CPR performance: A systematic review. Resuscitation. 2009;80(7):743–51. Epub 2009/05/30. doi: 10.1016/j.resuscitation.2009.04.012 19477574.

24. Riggs M, Franklin R, Saylany L. Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: A systematic review. Resuscitation. 2019;138:259–72. Epub 2019/04/01. doi: 10.1016/j.resuscitation.2019.03.019 30928504.

25. Cortegiani A, Russotto V, Montalto F, Iozzo P, Meschis R, Pugliesi M, et al. Use of a Real-Time Training Software (Laerdal QCPR(R)) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial. PLoS One. 2017;12(1):e0169591. Epub 2017/01/06. doi: 10.1371/journal.pone.0169591 eCollection 2017. 28056076.

26. Cortegiani A, Russotto V, Baldi E, Contri E, Raineri SM, Giarratano A. Is it time to consider visual feedback systems the gold standard for chest compression skill acquisition? Crit Care. 2017;21(1):166. Epub 2017/07/05. doi: 10.1186/s13054-017-1740-z 28673324.

27. Laerdal. CPR scoring explained. 2015 March 28, 2019. http://cdn.laerdal.com/downloads-test/f3784/Att_2_to_00021778.pdf.

28. Gluck KA, Harris J, editors. MindModeling@Home [Abstract]. Proceedings of the 30th Annual Meeting of the Cognitive Science Society 2008; Austin, TX: Cognitive Science Society.

29. Harris J, Gluck KA, Mielke T, Moore LR, editors. MindModeling@Home … and anywhere else you have idle processors [Abstract]. Proceedings of the Ninth International Conference on Cognitive Modeling; 2009; Manchester, United Kingdom: University of Manchester.

30. Core TR. R: A language and environment for statistical computing Vienna, Austria: R Foundation for Statistical Computing; 2019. http://www.R-project.org/.

31. Oermann MH, Muckler VC, Morgan B. Framework for teaching psychomotor and procedural skills in nursing. J Contin Educ Nurs. 2016;47(6):278–82. Epub 2016/05/28. doi: 10.3928/00220124-20160518-10 27232227.

32. Kardong-Edgren S, Oermann MH, Rizzolo MA. Emerging theories influencing the teaching of clinical nursing skills. J Contin Educ Nurs. 2019;50(6):257–62. Epub 2019/05/29. doi: 10.3928/00220124-20190516-05 31136668.

33. Dudzik LR, Heard DG, Griffin RE, Vercellino M, Hunt A, Cates A, et al. Implementation of a low-dose, high-frequency cardiac resuscitation quality improvement program in a community hospital. Jt Comm J Qual Patient Saf. 2019. Epub 2019/10/22. doi: 10.1016/j.jcjq.2019.08.010 31630977.


Článek vyšel v časopise

PLOS One


2020 Číslo 1