Cardiopulmonary resuscitation training for undergraduates from nonmedical majors: Effectiveness of the three tiers model
Corresponding Author
Sami M. Aloush
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Correspondence Sami M. Aloush, PhD, MSN, RN, Adult Health Nursing Department, Faculty of Nursing, Al al Bayet University, P.O. Box 130040, Mafraq 25113, Jordan. Email: [email protected]
Search for more papers by this authorAshraf Al Sabah
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorYasmeen Abu Sumaqa
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMarwa Halabi
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMohammed Al Bashtawy
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMohammad Suliman
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorFadia A. Abdelkader
Faculty of Nursing, Mansoura University, Mansoura, Egypt
Search for more papers by this authorCorresponding Author
Sami M. Aloush
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Correspondence Sami M. Aloush, PhD, MSN, RN, Adult Health Nursing Department, Faculty of Nursing, Al al Bayet University, P.O. Box 130040, Mafraq 25113, Jordan. Email: [email protected]
Search for more papers by this authorAshraf Al Sabah
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorYasmeen Abu Sumaqa
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMarwa Halabi
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMohammed Al Bashtawy
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorMohammad Suliman
Adult Health Nursing Department, Faculty of Nursing, Al al Bayt University, Mafraq, Jordan
Search for more papers by this authorFadia A. Abdelkader
Faculty of Nursing, Mansoura University, Mansoura, Egypt
Search for more papers by this authorAbstract
Background
Integrating cardiopulmonary resuscitation (CPR) in undergraduate education would help to increase the rate of bystander CPR. However, few qualified trainers are available for this purpose. Training student nurses to become CPR trainers on campus could reduce this shortage.
Purpose
The purposes of this study were to assess CPR skills of students from nonmedical majors and to examine the effectiveness of the three tiers model for CPR training.
Settings
One public university in Jordan.
Participants
Student nurses and undergraduates from nonmedical majors.
Method
Five student nurses attended CPR training courses based on the American Heart Association CPR guidelines. The trainees provided the same CPR training to a sample of 197 undergraduates from nonmedical majors. The participants were asked to imagine a real-life scenario of out-of-hospital cardiopulmonary arrest and to perform CPR on a manikin. Assessment of skills was made before and after training, using a structured observational checklist.
Results
In the pretest, participants showed poor CPR skills with a pass rate of only 4%. In the posttest, participants demonstrated significant improvement: t(196) = 26.78, P = 0.00.
Conclusion
The three tiers model for CPR training would be an effective strategy to compensate for the shortage in the number of certified CPR trainers.
CONFLICTS OF INTEREST
The authors declare that there are no conflicts of interest.
REFERENCES
- 1Cuijpers PJPM, Bookelman G, Kicken W, de Vries W, Gorgels APM. Medical students and physical education students as CPR instructors: an appropriate solution to the CPR-instructor shortage in secondary schools. Neth Heart J. 2016; 24(7-8): 456-461.
- 2Hansen CM, Lippert FK, Wissenberg M, et al. Temporal trends in coverage of historical cardiac arrests using a volunteer-based network of automated external defibrillators accessible to laypersons and emergency dispatch centers. Circulation. 2014; 137(1): 1-25. https://doi.org/10.1161/CIRCULATIONAHA.114.008850
- 3 American Heart Association. CPR facts and stats. CPR and emergency cardiovascular care. 2017a. http://cpr.heart.org/AHAECC/CPRAndECC/AboutCPRFirstAid/CPRFactsAndStats/UCM_475748_CPR-Facts-and-Stats.jsp Accessed 4 January 2018.
- 4 American Heart Association. CPR in Schools Training Kit™. CPR and first aid emergency cardiovascular care. 2017b. http://cpr.heart.org/AHAECC/CPRAndECC/Programs/CPRIn-Schools/UCM_473194_CPR-In-Schools.jsp Accessed 4 January 2018.
- 5Shimamoto T, Iwami T, Kitamura T, et al. Dispatcher instruction of chest compression-only CPR increases actual provision of bystander CPR. Resuscitation. 2015; 96: 9-15.
- 6Bobrow BJ, Spaite DW, Vadeboncoeur TF, et al. Implementation of a regional telephone cardiopulmonary resuscitation program and outcomes after out-of-hospital cardiac arrest. JAMA Cardiol. 2016; 1(3): 294-302.
- 7 Public Health—Seattle & King County Emergency Medical Services. 2015. Retrieved from http://www.kingcounty.gov/healthservices/health/ems/reports.aspx
- 8Brown L, Bottinor W, Carroll T, Hirsch G. CPR at the state fair: a 10-minute training session is effective in teaching bystander CPR to members of at-risk communities. J Am Coll Cardiol. 2016; 67(13): 2355.
- 9Riva G, Hollenberg J, Svensson L, et al. 11 Increase in bystander-cpr in sweden is associated with increased rates of compression-only CPR. BMJ Open. 2017; 7(Suppl 3): A4-A4. https://doi.org/10.1136/bmjopen-2017-EMSabstracts.11
- 10Meissner TM, Kloppe C, Hanefeld C. Basic life support skills of high school students before and after cardiopulmonary resuscitation training: a longitudinal investigation. Scand J Trauma Resusc Emerg Med. 2012; 20(31): 31. https://doi.org/10.1186/1757-7241-20-31
- 11Lin Y-Y, Chiang W-C, Hsieh M-J, Sun J-T, Chang Y-C, Ma MH-M. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: a systematic review and meta-analysis. Resuscitation. 2018; 123: 77-85.
- 12Lešnik D, Lešnik B, Golub J, Križmarić M, Mally Š, Grmec Š. Impact of additional module training on the level of basic life support knowledge of first year students at the University of Maribor. Int J Emerg Med. 2011; 4(1): 16. https://doi.org/10.1186/1865-1380-4-16
- 13Ohley W. Engineering student education in cardiopulmonary resuscitation via virtual reality. Resuscitation. 2016; 106: e51. https://doi.org/10.1016/j.resuscitation.2016.07.122
10.1016/j.resuscitation.2016.07.122 Google Scholar
- 14Wik L, Brennan RT, Braslow A. A peer-training model for instruction of basic cardiac life support. Resuscitation. 1995; 29(2): 119-128.
- 15Nakanishi T, Goto T, Kobuchi T, Kimura T, Hayashi H, Tokuda Y. The effects of flipped learning for bystander cardiopulmonary resuscitation on undergraduate medical students. Int J Med Educ. 2017; 8: 430-436.
- 16O'Toole-Baker V, Amann C, McElhaney S, McCarthy M, Carlson J. Implementing an undergraduate, team-based, first aid education course. International Journal of First Aid Education. 2017; 1(1): 13-28. https://doi.org/10.21038/ijfa.2017.0006
10.21038/ijfa.2017.0006 Google Scholar
- 17Nolan JP, Hazinski MF, Aickin R, et al. Part 1: Executive Summary: 2015 International Consensus On Cardiopulmonary Resuscitation And Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2015; 95: e1-e31.
- 18Malta hansen CM, Zinckernagel L, Ersbøll AK, et al. Cardiopulmonary resuscitation training in schools following 8 years of mandating legislation in Denmark: a nationwide survey. J Am Heart Assoc. 2017; 6(3): 1-12. https://doi.org/10.1161/JAHA.116.004128
- 19Semeraro F, Wingen S, Schroeder DC, et al. KIDS SAVE LIVES implementation in Europe: a survey through the ERC Research NET. Resuscitation. 2016; 107: e7-e9.
- 20Graham R, McCoy MA, Schultz AM. Strategies to Improve Cardiac Arrest Survival: A Time to Act. Washington, DC: National Academies Press; 2015.
- 21Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013; 310(13): 1377-1384.
- 22Salvatierra GG, Palazzo SJ, Emery A. High school CPR/AED training in Washington state. Public Health Nurs. 2017; 34(3): 238-244.
- 23Zinckernagel L, Malta Hansen C, Rod MH, Folke F, Torp-Pedersen C, Tjørnhøj-Thomsen T. What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools? A qualitative study. BMJ Open. 2016; 6(4): 1-8. https://doi.org/10.1136/bmjopen-2015-010481
- 24Bohn A, Van Aken HK, Möllhoff T, et al. Teaching resuscitation in schools: annual tuition by trained teachers is effective starting at age 10. A four-year prospective cohort study. Resuscitation. 2012; 83(5): 619-625.
- 25Charlier N, Van Der Stock L, Iserbyt P. Peer-assisted learning in cardiopulmonary resuscitation: the jigsaw model. J Emerg Med. 2016; 50(1): 67-73.
- 26Toner P, Connolly M, Laverty L, McGrath P, Connolly D, McCluskey DR. Teaching basic life support to school children using medical students and teachers in a ‘peer-training’ model—results of the ‘ABC for life’ programme. Resuscitation. 2007; 75(1): 169-175.
- 27Iserbyt P, Byra M. The design of instructional tools affects secondary school students’ learning of cardiopulmonary resuscitation (CPR) in reciprocal peer learning: a randomized controlled trial. Resuscitation. 2013; 84(11): 1591-1595.
- 28Breckwoldt J, Beetz D, Schnitzer L, Waskow C, Arntz H-R, Weimann J. Medical students teaching basic life support to school children as a required element of medical education: a randomised controlled study comparing three different approaches to fifth year medical training in emergency medicine. Resuscitation. 2007; 74(1): 158-165.
- 29Dezfulian C, Olsufka M, Fly D, et al. Hemodynamic effects of IV sodium nitrite in hospitalized comatose survivors of out of hospital cardiac arrest. Resuscitation. 2018; 122: 106-112.
- 30Kleinman ME, Goldberger ZD, Rea T, et al. 2017 American Heart Association focused update on adult basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018; 137(1): e7-e13.
- 31 American Heart Association. HIGHLIGHTS of the 2015 American Heart Association Guidelines Update for CPR and ECC. 2015. https://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf website
- 32 IBM. Statistical Package for the Social Sciences (SPSS). Armonk, NY: IBM; 2012.
- 33Hung MSY, Chow MCM, Chu TTW, et al. College students’ knowledge and attitudes toward bystander cardiopulmonary resuscitation: a cross-sectional survey. Cogent Med. 2017; 4(1): 1334408. https://doi.org/10.1080/2331205X.2017.1334408
10.1080/2331205X.2017.1334408 Google Scholar
- 34Bogle B, Mehrotra S, Chiampas G, Aldeen AZ. Assessment of knowledge and attitudes regarding automated external defibrillators and cardiopulmonary resuscitation among American University students. Emerg Med J. 2013; 30(10): 837-841.
- 35Lu C, Jin Y, Shi X, et al. Factors influencing Chinese university students’ willingness to performing bystander cardiopulmonary resuscitation. Int Emerg Nurs. 2017; 32: 3-8.
- 36Taniguchi T, Omi W, Inaba H. Attitudes toward the performance of bystander cardiopulmonary resuscitation in Japan. Resuscitation. 2007; 75(1): 82-87.
- 37Hart D, Flores-Medrano O, Brooks S, Buick JE, Morrison LJ. Cardiopulmonary resuscitation and automatic external defibrillator training in schools:“is anyone learning how to save a life?” Can J Emergency Med. 2013; 15(5): 270-278.
- 38Ma A, Wong K, Tou A, Vyas L, Wilks J. CPR knowledge and attitudes among high school students aged 15-16 in Hong Kong. Hong Kong J Emergency Med. 2015; 22(1): 3-13. https://doi.org/10.1177/102490791502200101
- 39Chair SY, Hung MS, Lui JC, Lee DT, Shiu IY, Choi KC. Public knowledge and attitudes towards cardiopulmonary resuscitation in Hong Kong: telephone survey. Hong Kong Medical J. 2014; 20(2): 126-133.
- 40Jimenez-Fabrega X, Escalada-Roig X, Miro O, et al. Comparison between exclusively school teacher-based and mixed school teacher and healthcare provider-based programme on basic cardiopulmonary resuscitation for secondary schools. Emerg Med J. 2009; 26(9): 648-652.
- 41Erdfelder E, Faul F, Buchner A. GPOWER: a general power analysis program. Behav Res Methods Instrum Comput. 1996; 28(1): 1-11.
- 42Swor R, Khan I, Domeier R, Honeycutt L, Chu K, Compton S. CPR training and CPR performance: do CPR-trained bystanders perform CPR. Acad Emerg Med. 2006; 13(6): 596-601.
- 43Atkins DL, Everson-Stewart S, Sears GK, et al. Resuscitation Outcomes Consortium Investigators. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation. 2009; 119(11): 1484-1491.
