Cardiopulmonary resuscitation training of family members before hospital discharge using video self-instruction: A feasibility trial

Background: Patients with a cardiac history are at future risk of cardiac events, including out-of-hospital cardiac arrest. Targeting cardiopulmonary resuscitation (CPR) training to family members of cardiac patients has long been advocated, but is an area in need of contemporary research evidence. An environment yet to be investigated for targeted training is cardiac rehabilitation. Aim: To evaluate the feasibility of providing CPR training in a cardiac rehabilitation programme among patients, their family members and staff. Methods: A prospective before and after study design was used. CPR training was delivered using video self-instruction CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Results: Cardiac patient participation rates in CPR classes were high ( n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use skills significantly increased post-training (both p<0.001). Post training participants demonstrated a mean compression rate of 112 beats/min and a mean depth of 48 mm. Training reach was doubled as participants shared the video self-instruction kit with a further 87 people. Patients, family members and cardiac rehabilitation staff had positive feedback about the training. Conclusions: We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using video self-instruction CPR training kits enabled further training reach to the target population.

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Abstract 445: Cardiopulmonary Resuscitation Training for Families of Cardiac Patients Before Hospital Discharge Using a Mobile Application

Circulation ◽

10.1161/circ.140.suppl_2.445 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

Audrey L Blewer ◽

Shaun K McGovern ◽

Andrew D Murray ◽

Marion Leary ◽

Mary Putt ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Mobile Application ◽

Prospective Trial ◽

Family Members ◽

Sudden Cardiac Arrest ◽

Cardiac Patients ◽

Skill Retention ◽

Resuscitation Training ◽

Self Instruction ◽

Cpr Training

Introduction: Since over 75% of sudden cardiac arrest events occur in the home where family members may be first responders, broad cardiopulmonary resuscitation (CPR) training for family members of high-risk cardiac patients represents a promising intervention. The use of mobile application-based (mApp) CPR training may facilitate this, but data on the approach are limited. Objectives: We compared CPR skill retention among those trained with an mApp and hypothesized that training with the mApp would be non-inferior to training with a well-established video self-instruction (VSI) kit. As a secondary analysis, we examined dissemination via the “multiplier rate” (i.e., those additionally trained by primary trainees) by intervention. Methods: We conducted a multicenter pragmatic, randomized control trial assessing non-inferiority of training family members of cardiac patients in CPR with an mApp (video, but no practice manikin) to training with an established VSI method (video and manikin). Subject’s CPR skills were tested 6-months post-training. We hypothesized that mApp training would be non-inferior to VSI training, with a non-inferiority margin set at 5 chest compressions (cc) per min. Results: From 01/2016-01/2018, 1446 subjects were enrolled at 8 hospitals with 685 trained with VSI, and 761 trained with the mApp. Of those, 541 were included in the skills analysis (275 VSI, 266 App). The mean age was 52±16 years and 69% were female. Mean cc rate was 85±34 per min; mean cc depth was 40±14 mm. When stratified by intervention arm, those trained with VSI had a mean rate of 86 per min (83, 90), compared to 88 per min (84, 92) with the mApp; those trained with VSI had a mean depth of 42 mm (41, 44), compared to 39 mm (38, 41) with the mApp. Findings were similar when accounting for loss to follow-up. We concluded non-inferiority of the mApp with a mean difference of 1 (-5, 7) cc per min for rate. Subjects trained with VSI shared with an additional 2±4 individuals compared to 1±2 (p<0.01) of those trained with the mApp. Conclusion: In this large prospective trial of CPR skill retention, the mApp CPR training approach was non-inferior to VSI training for family members of cardiac patients. Future work may include evaluating additional means for adoption and dissemination of the mApp.

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Attitudes of health professionals towards cardiopulmonary resuscitation training for family members of cardiac patients

Coronary Health Care ◽

10.1016/s1362-3265(99)80021-2 ◽

1999 ◽

Vol 3 (2) ◽

pp. 91-98 ◽

Cited By ~ 6

Author(s):

K.G. Lie ◽

M. Richardson

Keyword(s):

Cardiopulmonary Resuscitation ◽

Health Professionals ◽

Family Members ◽

Cardiac Patients ◽

Resuscitation Training

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Cardiopulmonary Resuscitation Training for Family Members

Dimensions of Critical Care Nursing ◽

10.1097/dcc.0b013e3181a473ae ◽

2009 ◽

Vol 28 (4) ◽

pp. 156-163 ◽

Cited By ~ 2

Author(s):

Haiyan Liu ◽

Angela P. Clark

Keyword(s):

Cardiopulmonary Resuscitation ◽

Family Members ◽

Resuscitation Training

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Abstract P193: A Cardiopulmonary Resuscitation Training Program for Family Members of In-Hospital Patients at Risk for Cardiac Arrest

Circulation ◽

10.1161/circ.118.suppl_18.s_1487-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Marion Leary ◽

Lori Albright ◽

Emily B Meshberg ◽

Noah T Sugerman ◽

Lance B Becker ◽

...

Keyword(s):

At Risk ◽

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Family Members ◽

Care Hospital ◽

Hospital Patients ◽

Patients At Risk ◽

Bystander Cpr ◽

Self Instruction

Background: Resuscitation from cardiac arrest often depends on prompt cardiopulmonary resuscitation (CPR) from the lay public, yet bystander CPR rates in the US are low. One barrier to bystander CPR delivery is that most arrests occur in the home, where only family members may be available to provide care. Little data exist regarding the ability to target and train family members of “at-risk” patients in CPR. Objective: We sought to implement a CPR video self-instruction (VSI) program for family members of in-hospital patients at risk for cardiac arrest. After training in situ before hospital discharge, we tested the hypothesis that at-risk patient family members would be motivated to secondarily train others in the home after leaving the hospital setting. Methods: Family members of patients hospitalized for cardiac conditions at one tertiary-care hospital between 12/07 and 6/08 who met pre-defined inclusion criteria were offered CPR VSI training requiring 25–30 min. All trainees were assessed for skill competence and video recorded for analysis. Trainees were encouraged to take the VSI kit home, and follow-up surveys were conducted to gauge secondary training of other family members. Results: Among 36 enrollees, mean age (SD) was 50 (13) and 78% of trainees were female; only 17% had been CPR trained within the past 10 years, and 44% had never been trained. Most (67%) of the trainees were either children or spouses of the at-risk hospitalized patients. Most (78%) trainees rated their experience with learning CPR via VSI as “comfortable” or “very comfortable”. During 2 min of CPR skills assessment, mean (SD) chest compression rate was 100 (19), mean percentage (SD) adequate depth was 89% (15%), and mean (SD) time for two breaths was 10.8 (4.6) sec. Follow-up surveys revealed that 33% of recipients performed secondary training at home, with a mean (SD) of 1.8 (1.3) secondary trainees. Conclusions: CPR VSI training for family members of hospitalized cardiac patients may serve as a cost-effective model to disseminate resuscitation skills and allows for secondary training in the home of patients at risk for sudden cardiac arrest.

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