Please use this identifier to cite or link to this item: http://hdl.handle.net/10311/1924
Title: Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques
Authors: Tsima, Billy
Meaney, Peter A.
Sutton, Robert M.
Steenhoff, Andrew P.
Shilkofski, Nicole
Boulet, John R.
Davis, Amanda
Kestler, Andrew M.
Church, Kasey K.
Niles, Dana E.
Irving, Sharon Y.
Mazhani, Loeto
Nadkarni, Vinay M.
Keywords: Developing countries
emergency training
resuscitation education
CPR
chest compression
competence
resource-limited setting
basic life support
cardiopulmonary resuscitation
manikin
Issue Date: Dec-2012
Publisher: Elsevier, www.elsevier.com
Citation: Tsima, B. et al (2012) Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques. Resuscitation, Vol. 83, No. 12, pp. 1484-1490
Abstract: Objective—Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. Methods—HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Results—Of 214 HCP trained, 40% resuscitate ≥1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p < 0.01; adult 28% vs. 48%, p < 0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p < 0.01) and 6 months (38% vs. 67%, p < 0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p = 0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. Conclusions—HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction.
URI: http://hdl.handle.net/10311/1924
ISSN: 0300-9572
Appears in Collections:Research articles (School of Medicine)

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