Effectiveness of cardiopulmonary resuscitation training in the teaching of family members of cardiac patients

Citolino Filho, Clairton Marcos; Nogueira, Lilia de Souza; Gomes, Vanessa Miranda; Polastri, Thatiane Facholi; Timerman, Sergio

doi:10.1590/1980-220X-REEUSP-2021-0459en

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ORIGINAL ARTICLE • Rev. esc. enferm.ASSOCIATE EDITOR USP 56 (spe) • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0459en copy

Effectiveness of cardiopulmonary resuscitation training in the teaching of family members of cardiac patients^* * Extracted from the dissertation: “Efetividade de um treinamento na aprendizagem de familiares de pacientes cardiopatas sobre ressuscitação cardiopulmonar”, Universidade de São Paulo, Escola de Enfermagem, 2019.

Efectividad del entrenamiento sobre resucitación cardiopulmonar en el aprendizaje de familiares de pacientes cardíacos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the effectiveness of a cardiopulmonary resuscitation training in the skill acquisition of family members of heart disease patients.

Method:

A quasi-experimental study, conducted in a hospital in São Paulo, Brazil. The study participants were one or more relatives of patients with heart disease that were hospitalized at the institution. In the first phase, the participant’s skills and theoretical knowledge on cardiopulmonary resuscitation were evaluated before and immediately after the training. The second phase took place one month after the training, in which the same evaluations were applied. The McNemar’s and Stuart-Maxwell tests were adopted (5% significance level).

Results:

The theoretical knowledge of family members before and after training increased and a great retention of this knowledge after 30 days of training was observed. Immediately after training, the family members showed significant improvement of skills in the 15 analyzed actions and, after one month of training, they maintained most of the acquired practices on cardiopulmonary resuscitation, except for chest compressions frequency and the time between turning on the defibrillator and delivering the shock.

Conclusion:

Cardiopulmonary resuscitation training was effective in the acquisition of theoretical and practical knowledge of the family members.

DESCRIPTORS
Family; Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Nurses; Simulation Training; Effectiveness

Demographic characteristic	n (%)	Mean (SD)
Male	17 (28.33)
Female	43 (71.67)
Age		36.22 (11.49)

Questions – theoretical evaluation	Pre-training		Post-training		p*
	Right answers		Right answers		p*
	n	%	n	%
1. What do you do to make sure a person is unconscious?	38	63.30	57	95.00	<0.001
2. After verifying that the person is not responding, what do you do?	50	83.30	59	98.30	0.032
3. How do you identify if the person is breathing?	51	85.00	60	100.00	0.008
4. To perform chest compressions (cardiac massage), in what position should the person in cardiac arrest be?	48	80.00	59	98.30	0.005
5. In the case of a person in cardiac arrest, in which place would you do chest compressions (cardiac massage)?	49	81.70	60	100.00	0.005
6. How often would you do chest compressions (cardiac massage) in the person in cardiac arrest?	5	8.33	59	98.30	<0.001
7. What minimum depth would you perform chest compressions (cardiac massage) on the person in cardiac arrest?	4	6.67	53	88.30	<0.001
8. To ensure high quality care for a person in cardiac arrest, I must…	11	18.30	44	73.30	<0.001
9. What number would you call for help?	44	73.30	59	98.30	0.001
10. If an automatic external defibrillator (AED) is available, what would you do?	15	25.00	60	100.00	<0.001

Actions – practical evaluation	Right		Remedied		Wrong		p*
	Pre	Post	Pre	Post	Pre	Post
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
1. Assessed scene safety	2 (3.33)	55 (91.70)	–	–	58 (96.67)	5 (8.30)	<0.001
2. Assessed responsiveness (by tapping and calling the victim aloud)	17 (28.33)	56 (93.30)	2 (3.33)	2 (3.33)	41 (68.34)	2 (3.37)	<0.001
3. Called for help (192)	19 (31.66)	17 (28.30)	1 (1.67)	20 (33.30)	40 (66.67)	23 (38.40)	<0.001
4. Checked breathing (chest or abdomen movement) – 5 to 10 seconds	10 (16.67)	45 (75.00)	–	3 (5.00)	50 (83.33)	12 (20.00)	<0.001
5. Correctly positioned hands during chest compressions	18 (30.00)	60 (100.00)	–	–	42 (70,00)	–	<0.001
6. Performed a minimum amount of 100 and a maximum of 120 chest compressions per minute	4 (6.67)	58 (96.70)	–	–	56 (93.33)	2 (3.30)	<0.001
7. Maintained minimum depth of 5 cm and maximum of 6 cm at each chest compression	5 (8.33)	55 (91.70)	–	–	55 (91.67)	5 (8.30)	<0.001
8. Allowed chest to return to its original position at each chest compression	6 (10.00)	60 (100.00)	–	–	54 (90.00)	–	<0.001
9. Did not interrupt chest compressions	2 (3.33)	60 (100.00)	–	–	58 (96.67)	–	<0.001
10. Turned on the AED	–	53 (88.30)	–	7 (11.70)	60 (100.00)	–	<0.001
11. Connected the electrodes in the correct position	–	59 (98.30)	–	–	60 (100.00)	1 (1.70)	<0.001
12. He followed instructions from the AED and asked aloud for everyone to clear away during the analysis and shock	–	60 (100.00)	–	–	60 (100.00)	–	<0.001
13. Delivered the shock to the victim	–	60 (100.00)	–	–	60 (100.00)	–	<0.001
14. Started CPR immediately after the shock	–	60 (100.00)	–	–	60 (100.00)	–	<0.001
15. Time between turning on the AED and delivering the shock – up to 45 seconds	–	53 (88.30)	–	–	60 (100.00)	7 (11.70)	<0.001

Questions – theoretical evaluation	Post-training Right answers		After 30 days of training Right answers		p*
Questions – theoretical evaluation	n	%	n	%	p*
1. What do you do to make sure a person is unconscious?	49	98.00	47	94.00	0.617
2. After verifying that the person is not responding, what do you do?	49	98.00	47	94.00	0.617
3. How do you identify if the person is breathing?	50	100.00	50	100.00	1.000
4. To perform chest compressions (cardiac massage), in what position should the person in cardiac arrest be?	49	98.00	46	92.00	0.248
5. In the case of a person on cardiac arrest, in which place would you do chest compressions (cardiac massage)?	50	100.00	45	90.00	0.074
6. How often would you do the cardiac massage in the person in cardiac arrest?	49	98.00	38	76.00	0.003
7. What minimum depth would you perform chest compressions (cardiac massage) on the person with cardiac arrest?	44	88.00	44	88.00	1.000
8. Allowed chest to return to its original position at each chest compression	36	72.00	31	62.00	0.332
9. What number would you call for help?	50	100.00	45	90.00	0.074
10. If an automatic external defibrillator (AED) is available, what would you do?	50	100.00	50	100.00	1.000

Actions – practical evaluation	Right		Remedied		Wrong		p*
	Post	30 days after	Post	30 days after	Post	30 days after
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
1. Evaluated site security	47 (94.00)	50 (100.00)	–	–	3 (6.00)	–	0.083
2. Evaluated responsiveness (by tapping and calling the victim aloud)	47 (94.00)	46 (92.00)	1 (2.00)	2 (4.00)	2 (4.00)	2 (4.00)	0.564
3. Called for help (192)	13 (26.00)	24 (48.00)	18 (36.00)	16 (32.00)	19 (38.00)	10 (20.00)	0.008
4. Checked breathing (chest or abdomen movement) – 5 to 10 seconds	38 (76.00)	39 (78.00)	2 (4.00)	1 (2.00)	10 (20.00)	10 (20.00)	0.317
5. Correctly positioned hands during chest compressions	50 (100.00)	47 (94.00)	–	–	–	3 (6.00)	0.083
6. Performed a minimum amount of 100 and a maximum of 120 chest compressions per minute	48 (96.00)	37 (74.00)	–	–	2 (4.00)	13 (26.00)	0.002
7. Maintained minimum depth of 5 cm and maximum of 6 cm at each chest compression	45 (90.00)	42 (84.00)	–	–	5 (10.00)	8 (16.00)	0.257
8. Allowed chest to return to its original position at each chest compression	50 (100.00)	48 (96.00)	–	–	–	2 (4.00)	0.157
9. Did not interrupt chest compressions	50 (100.00)	50 (100.00)	–	–	–	–	1.000
10. Turned on the AED	44 (88.00)	37 (74.00)	6 (12.00)	13 (26.00)	–	–	0.108
11. Connected the electrodes in the correct position	49 (98.00)	44 (88.00)	–	1 (2.00)	1 (2.00)	5 (10.00)	0.082
12. He followed instructions from the AED and asked aloud for everyone to clear away during the analysis and shock	50 (100.00)	49 (98.00)	–	1 (2.00)	–	–	0.317
13. Delivered the shock to the victim	50 (100.00)	49 (98.00)	–	1 (2.00)	–	–	0.317
14. Started CPR immediately after the shock	50 (100.00)	49 (98.00)	–	1 (2.00)	–	–	0.317
15. Time between turning on the AED and delivering the shock – up to 45 seconds	44 (88.00)	35 (70.00)	–	–	6.0 (12.00)	15 (30.00)	0.039

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author:

Clairton Marcos Citolino Filho

Avenida Doutor Enéas de Carvalho Aguiar, 419, Cerqueira César

05403-000 – São Paulo, SP, Brazil
clairtonmarcos@yahoo.com.br