Cardiopulmonary Resuscitation Competencies of Nurses and Ninth Grade Students.

Abstract

The purposes of this study were to determine how many nurses and ninth grade students from a target population could perform cardiopulmonary resuscitation (CPR) properly after instruction and demonstration in CPR and how long cognitive and psychomotor skills relating to CPR were retained. The hypotheses of this study held that there would be (1) no significant difference in cognitive knowledge of CPR demonstrated by a written test and perceptual motor skills in performing CPR on a mannequin, (2) no significant difference in nurses' cognitive knowledge of CPR on pre-test and after instruction in CPR, (3) no correlation between the amount of time elapsed since CPR training and the degree of competence demonstrated in performing CPR on a mannequin, and (4) no correlation between the amount of time elapsed since CPR instruction and the degree of cognitive knowledge relating to CPR as evidenced by performance on a written examination. Ninety nurses volunteered to participate in this study and were given the American Heart Association Basic Life Support Written Examination as a pre-test. The entry level knowledge of these nurses was found to be inadequate to bypass further instruction and training in CPR. Significant differences were found in knowledge according to the level of academic preparation of the nurses, the area of clinical practice, and whether they had ever actually performed CPR on a real person. Perceptual motor skills were significantly better than written test scores for the nurses as well as for the ninth grade students. Over the sixth month period of the study, thirty of the original ninety nurses in the study became unavailable for follow-up testing. The high attrition rate made inferences relating to retention of knowledge and skills over time difficult. However, all of the nurses learned a significant amount from instruction and demonstration in CPR. The follow-up test scores which dropped over time, never fell back to the pre-test level during the six months of the study. 230 ninth grade students were instructed in CPR as part of the required health class in their high school. Ninety of these students volunteered to participate in follow-up testing. The thirty students tested two months following instruction in CPR had a mean score of 97.0% on the psychomotor test of CPR. The thirty students tested four months after instruction had a mean score of 95.67% on the CPR demonstration on the mannequin. While the group of thirty students tested six months after instruction had a mean score of 85.33% on the same test. There was a marked drop in perceptual motor skills between the fourth and the sixth months following instruction. Two students reported that they had actually performed CPR on family members since being instructed and had been successful since the family members survived. The findings indicate that CPR is a skill that ninth grade students can learn and master. Nurses need instruction in CPR beyond what is provided in the basic nursing curriculum. Since many things affect retention, it is recommended that follow-up training and practice be offered to ensure continued competence in CPR when the need arises. If CPR can save lives, then professional health care workers and members of the lay public should be reinstructed and re-tested to ensure continued competence.