Assessment of cardiopulmonary resuscitation knowledge and skills among healthcare providers at an urban tertiary referral hospital in Tanzania

Winfrida T Kaihula,Hendry R Sawe,Michael S Runyon,Brittany L Murray

doi:10.1186/s12913-018-3725-2

Abstract

BackgroundEarly and effective CPR increases both survival rate and post-arrest quality of life. In limited resource countries like Tanzania, there is scarce data describing the basic knowledge of CPR among Healthcare providers (HCP). This study aimed to determine the current level of knowledge on, and ability to perform, CPR among HCP at Muhimbili National Hospital (MNH).MethodsThis was a descriptive cross sectional study of a random sample of 350 HCP from all cadres and departments at MNH from October 2015 to March 2016. Each participant completed a with 25 question multiple choice and fill-in-the-blank CPR test and a practical test using a CPR manikin where the participant was videotaped for 1–2 min. Two expert observers independently viewed the videos and rated participant performance on a structured data form. The primary outcome of interest was staff member overall performance on the written and practical CPR testing.ResultsWe enrolled 350 HCPs from all 12 MNH clinical departments. The median participant age was 35 (IQR 29–43) years, 225 (64%) were female and 138 (39%) had clinical experience of less than 5 years. Only 57 (16%) and 88 (25%) scored above 50% in written and practical tests, respectively according to local minimum passing test score and 13(4%) and 30 (9%) scored above 75% in written and practical tests, respectively according to international minimum passing test score on CPR. The 233(67%) HCP who reported prior experience performing CPR on an adult patient scored higher on testing than those without; 40% (IQR 28–54) versus 26% (IQR 16–42) respectively, but both groups had median scores <50%.ConclusionThe level of CPR knowledge and skills displayed by all cadres and in all departments was poor despite the fact that most providers reported having performed CPR in the past. Since MNH is a tertiary referral hospital, it may reflect the performance of resuscitation status of other local health centers in Tanzania and other low-income countries to employ a formal system of training every HCP in CPR. Staff should be certified and assessed regularly to ensure retention of resuscitation knowledge and skills.

Highlights

And effective cardiopulmonary resuscitation (CPR) increases both survival rate and post-arrest quality of life
Demographics A total of 350 participants from 12 Muhimbili National Hospital (MNH) departments were selected and all responded by answering self-administered questionnaires and demonstrating practical aspects of CPR on a manikin
There was a significant difference in the overall performance on testing between those who had and had not performed CPR in the past with median test scores of 40%(IQR 28–54) and 26%(IQR 16–42) respectively, p = 0.001 (Table 2)

Summary

Introduction

And effective CPR increases both survival rate and post-arrest quality of life. CPR is modified into a simple version of skills that can be learned by anyone regardless of formal medical training [3]. In the hospital, this allows any trained staff member to rapidly initiate this live saving treatment [4]. The incidence of in-hospital cardiac arrest attended by a resuscitation teams and receiving CPR is approximately 2 per 1000 admissions [5]. In such settings, the training of staff members and the introduction of resuscitation teams and pre-employment requirements of CPR certification have resulted in improvement of outcomes of in-hospital cardiac arrest [6]. In most parts of Africa, studies have shown health care providers (HCPs) to have poor knowledge and skills of CPR despite attempting to do resuscitation [8,9,10]

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