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Retention of basic cardiac life support skills by nurses following retraining

University of British Columbia

The expectation that nurses be competent in Basic Cardiac Life Support (BCLS) is today a forgone conclusion. The question is no longer should nurses be trained in BCLS, but how to ensure competency once initial training is complete. This study aspired to answer two questions: (a) after retraining to American Heart Association (AHA) standards, how long does it take for nurses' BCLS performance (on adults) to again drop below AHA standards, and (b), is there a relationship between nurses' demographic characteristics and their BCLS performance, upon retesting. Skinner's operant conditioning theory guided the development of the research proposal. Skinner argues that reinforcement is the key to maintaining behavior in strength. Thus, it is important to identify when reinforcement of BCLS skills becomes necessary and what factors in nurses' backgrounds, or environments, if any, are possible sources of reinforcement. Initially, nurses were trained in BCLS to AHA, level one standards, and data regarding their demographic characteristics were collected. These nurses were then asked to return for retesting (and further training as necessary) at 3, 6, and 9 week intervals. Due to attrition, it became necessary to analyze the data based on the actual time elapsed between tests (3 to 18 weeks). For example, if a nurse missed the 3 and 6 week tests and was then tested at what would have been the 9 week test the actual elapsed time between training and testing was 18 weeks (3 + 6 + 9=18). BCLS performance data was collected in two forms-score and pass or fail. Analyses of the data demonstrated there to be no significant difference in the number of nurses failing to meet AHA standards at each of the 3 week test intervals. Nurses failed BCLS tests as early as 3 weeks after inital retraining. No significant relationship was found between nurses' BCLS performance (retention) and age, education, position, specialty, prior BCLS training, number of exposures to, and participations in BCLS events, and recency of the last exposure to an obstructed airway. There did however appear to be a significant negative relationship between the number of years worked and BCLS performance and between number of years since graduation and BCLS performance. There also appeared to be a significant negative relationship between CPR performance and the recency of the last exposure to/participation in a cardiopulmonary arrest. Unfortunately, threats to internal validity, in particular attrition and small sample size limit confidence in the research findings. Findings supplemental to the research project are also outlined. In view of the study findings, implications for BCLS education for nurses and implications for further research into BCLS retention are delineated.

Text

2010-07-15

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http://hdl.handle.net/2429/26477

Educational Administration and Leadership

University of British Columbia

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