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Cardiopulmonary resuscitation skill maintenance for primary care staff: brief training sessions with feedback

Moreno S, Sisó-Almirall A, Kostov B, Expósito M, Moreno JR, de Pablo B, Coll-Vinent B

Centre d‚ÄôUrg√®ncies d‚ÄôAtenci√≥ Prim√†ria (CUAP) Gr√†cia, Parc Sanitari Pere Virgili, Barcelona, Spain. Grup de Recerca Transversal en Atenci√≥ Prim√†ria, Institut d‚ÄôInvestigaci√≥ Biom√®dica August Pi i Sunyer (IDIBAPS), Consorci d‚ÄôAtenci√≥ Prim√†ria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain. √Ārea B√°sica de Salud (ABS) Sabadell Nord, Institut Catal√† de la Salut (ICS), Barcelona, Spain. Servei Emerg√®ncies M√®diques (SEM), Bombers de la Generalitat, Barcelona, Spain. Serveid‚ÄôUrg√®ncies, Hospital Universitari M√ļtua de Terrassa, Barcelona, Spain. √Ārea de Urgencias, Hospital Cl√≠nic, Universidad de Barcelona, Barcelona, Spain.

Objective. Cardiopulmonary resuscitation (CPR) feedback applications can facilitate learning in brief training sessions, but they have never been tested in primary care settings. We aimed to see if brief CPR training sessions that include feedback improve the skills of primary care staff.
Methods. Randomized trial with a control group and 2 intervention groups (G) using the feedback app and a control group: in G1, the instructor gave spoken feedback to the trainee and both could see the app; in G2, only the instructor giving feedback could see the app; and in G3, the control group, neither the instructor nor the trainee could see the app. All trainees received 10 minutes of instruction on theory followed by 6 minutes of practical instruction according to group assignment. The trainees used a high-quality CPR manikin connected to the Skillreporter feedback app (Laerdal Medical). CPR results were measured immediately before and after training and 6 months later. The main outcome measure was the overall CPR quality score. Secondary outcomes were 6 measures related to compressions and 5 related to ventilation.
Results. The main outcome improved with statistical significance in the two intervention groups (G1 and G2) respect to controls (G3). Most secondary outcome measures also improved after training. Trainees in the intervention groups scored better than trainees in G3 on the compression score (G1, P = .012), mean compression depth (G1, P = .001; G2, P = .022), number of compressions with adequate depth (G1, P = .026; G2, P = .019), and number of ventilations at adequate volume (G1, P = .033). The 2 intervention groups achieved statistically similar results. At 6 months, all outcome measures remained slightly improved over baseline levels, there were no between-group differences.
Conclusions. Brief retraining sessions with feedback are useful for maintaining CPR skills in primary care, but skill improvement is not long lasting.

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