CPR Refresher Role in Retaining Psychomotor Skills (RefCPR)

The study aims to measure the effectiveness of refresher training after six months of baseline training on retention of CPR skills. Literature review and guidelines showed that there is significant decay in CPR skills after basic life support certification. This retention might be preserved as short as three months after basic life support certification. Frequent retraining within the standard two years of recertification was recommended. Recommendation did not specify the ideal timing and method for CPR refresher training. In this study, we are looking for a feasible, practical, easily applicable method for health care institute in order to maintain the required CPR skills. This study will be a randomized control trial in which the study group will be tested for their CPR skills at six and twelve months after CPR training before the start of the study and after six months assessment. The control group will be tested after twelve months from the initial training at the start of the research and with no CPR refresher in between. The outcome of the study will assess the effectiveness of a BLS refresher training at six months on retention of quality of CPR skills.

This is a prospective study that will enrol nurses, doctors and respiratory therapists of the Sultan Taboos university hospital,emergency departments from February 2018 until February 2019. All participants will be verbally consented before enrolment. Participants can withdraw from the study at any stage. All subjects will be assessed initially for their baseline skills of CPR. Assessment will be through measuring the baseline performance of the subjects. This will be two minutes of CPR in which chest compression rate, depth, chest recoil, interruption and ventilation will be assessed. CPR meter device will be used in each CPR assessment throughout the study. After that, all participants will receive CPR training which includes 15minutes standard CPR video followed by five minutes instructor- led teaching in manikins. Individual CPR performance will be assessed for each subject and data will be collected using a standardized data collection sheet. Next, groups will be randomized into two different groups using stratified sampling method to account for the years of experience. Participants will be divided into groups based on experience; 0-5, 5-10, 10-15, 15-20 and more than 20 years. Research randomizer (https://www.randomizer.org) program will be used for this purpose. Then, subjects will be randomized into study(group1) and control(group2) group. Both groups will be called after 6 months. Pre-assessment test will be conducted, which is similar to the baseline assessment test, for both groups using the same standardized data collection sheet. Then, study group will receive refresher training of CPR while the control group will be released with no training. Six months later, both groups will be called and CPR skills will be assessed again. CPR performance will be monitor and assessed by using Little Anne manikin which has quality CPR (QCPR) monitoring through smart devises. This will provide data for each performer including chest compression rate and depth, chest recoil and adequate ventilation. Data of each subject will be stored in the devise and then will be transferred to software for storage and analysis.

Randomized controlled study. Experimental group would receive a refresher training at six months wherease the control receive not training.

a 5 cycles of 30:2 compression to ventilation ratio will be offered to experimental group at six months from BLS certification.

Chest compression rate ( number of compression per minute) Descriptive statistics will be presented as a mean ± standard deviation by using student t-test

Inclusion Criteria: All sultan Taboos university hospital staff in emergency department( nurses, doctors and respiratory therapists) who received basic life support training Age more than 18 years old Exclusion Criteria: Medical illnesses that interfere with chest compression (back pain, wrist pain, knee pain) Pregnancy Providers who are scheduled for refresher training

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