A follow‐up report on the effect of a simplified basic life support training program for non‐medical staff working at a university hospital: changes in attitude toward cardiopulmonary resuscitation and automated external defibrillator use through repeat training

Abstract Background Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an automated external defibrillator (AED) and can be regarded as multipliers of knowledge that can reach the whole population. This study aimed to develop and validate a test for examining levels of knowledge about BLS and AED among schoolchildren that can be used to uniformly present reliable data. Methods A knowledge test about BLS and AED consisting of 10 multiple-choice questions was developed and implemented before and after a 2-h BLS and AED course consisting of an interactive lecture and a practical workshop for 783 students in seventh and ninth grades of elementary schools in Maribor, Slovenia. Each question was analyzed and presented with descriptive statistics and educometric parameters (difficulty and discriminating indices). All variables were checked for normality with the Kolmogorov-Smirnov test and analyzed using non-parametric tests. Statistical significance of the differences in knowledge before and after intervention were calculated with chi-square statistics and effect sizes r are reported. Differences between genders, grades and previous attendance to BLS courses were compared using Mann – Whitney U test. The effect size was calculated from the Z score and reported as r value. Results After educometric analysis, questions were adjusted to meet the requirements of satisfactory functioning difficulty and discriminating indices (values between 0,40 and 0,60, and above 0,20, respectively). Only one question had to be eliminated due to inadequate difficulty and discriminating index (0,99 and 0,02, respectively). Measurement invariance across gender (p < 0,001), school grade (p < 0,001), and attendance to previous courses (p = 0,303) was assured. Conclusions A test for accurate and reliable measurement of knowledge of BLS and AED among schoolchildren was developed and validated. According to the findings it can now reliably be used to assess baseline knowledge and potential improvement in knowledge after a course on BLS and AED. Standardized data gathered with a validated tool can now be presented at legislative levels to promote BLS and AED courses implementation in school curricula.

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Brief compression-only cardiopulmonary resuscitation and automated external defibrillator course for secondary school students: a multischool feasibility study

BMJ Open ◽

10.1136/bmjopen-2020-040469 ◽

2020 ◽

Vol 10 (10) ◽

pp. e040469

Author(s):

Kit Ying So ◽

Hiu Fai Ko ◽

Cindy Sin Yui Tsui ◽

Chi Yeung Yeung ◽

Yee Ching Chu ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Secondary School ◽

Secondary Schools ◽

Feasibility Study ◽

Secondary School Students ◽

Life Support ◽

Attitude Score ◽

Automated External Defibrillator ◽

School Students ◽

External Defibrillator

ObjectivesThis study assessed the feasibility and preliminary efficacy of a 2-hour compression-only cardiopulmonary resuscitation and automated external defibrillator (CO-CPRAED) course in secondary school students.DesignProspective pre-post feasibility study.Setting and participants128 students (12–15 years old) without prior basic life support (BLS) training at four secondary schools in Hong Kong. All students were followed up at 3 months after training.InterventionsEmergency medicine-trained nurse and physicians taught the 2-hour CO-CPRAED course using the American Heart Association ‘CPR in School Training Kit’ programme. Students were trained in groups up to 40 students/session, with an instructor to student ratio not exceeding 1:10. To practise hands-on compressions, the manikin to student ratio was 1:1. For a simulated cardiac arrest, the manikin and AED to student ratio was 1:10.Primary and secondary outcomesCPR and AED knowledge, attitude statements towards bystander CPR and AED, quality of BLS performance skills during training and at 3 months.ResultsSome students (46%) knew how deep to push on an adult chest when doing CO-CPR before training. The course was associated with an increase in knowledge score (pretraining 55%, post-training 93%; adjusted mean difference (MD) 38%, 95% CI 33% to 43%; p<0.001). Most students (68%) thought that CPR education in senior secondary school was essential before training. The students had a very positive attitude towards CPR; no change in the mean (SD) attitude score out of 30 over time (pretraining 27.2 (2.5), post-training 27.6 (2.7); adjusted MD 0.5, 95% CI −0.1 to 1.0; p=0.132). Most students were competent in performing BLS immediately after training (77%) and at 3 months (83%) (adjusted MD 6%, 95% CI −4% to 15%; p=0.268).ConclusionsThe results demonstrate the feasibility of scaling up the number of secondary schools trained in a brief CO-CPRAED course within the local school curriculum.

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