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Discrepancies exist between perception, reality of CPR performance among health care professionals
Differences in attitudes between the United States and European nations were also reported.
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American Heart Association Scientific Sessions 2009
Although health care professionals have a favorable perception of their ability to perform cardiopulmonary resuscitation, research indicates improvement is needed.
The CPR Working Group, through the commissioning of a multinational attitudinal Ipsos Health poll of 1,023 health care professionals, attempted to quantify the attitudes of a variety of health care workers regarding CPR and of their performance of CPR. The survey, believed to be the largest of its kind, included paramedics, physicians and nurses from the United States (n=454), the United Kingdom (n=159), France (n=183) and Germany (n=227).
Perception vs. reality of CPR performance
According to the survey results, 75% of health care professionals perceive their level of skill at performing CPR as “very well” or “well.” In addition, 55% of the health care professionals surveyed believe that studies of CPR indicate the quality of CPR in those studies was either excellent or good. However, study results suggest that current CPR quality is poor, according to the survey. A total of 87% of respondents believed CPR is either very important or important to overall patient outcomes.
In general, respondents also stated they were familiar with the American Heart Association/International Liaison Committee on Resuscitation 2005 CPR guidelines (68% reported being familiar or somewhat familiar), and 90% agreed or somewhat agreed they performed CPR according to the 2005 standards. In reality, only 26% of respondents reported they performed compression rate, compression depth and compression-to-ventilation ratio in full compliance with the guidelines, leaving a performance gap of 74%.
Variations according to country
The perceptions of CPR performance and familiarity with established guidelines varied according to country. Health care professionals in the United States had a higher perceived knowledge (90%) and perceived level of skill (84%) than health care professionals in the United Kingdom (84% and 64%), France (70% and 59%) and Germany (88% and 79%). French health care professionals were the most likely to realize that CPR performance studies indicated CPR quality is poor (25%).
Health care professionals in the United States (27%) and United Kingdom (21%) were also less likely to receive regular feedback regarding CPR performance than professionals in France (32%) and Germany (35%). Physicians in all three European countries were more likely to want to attend CPR training more frequently compared with physicians in the United States, who were more likely to think the current rate of training attendance was appropriate (68%).
“What the survey tells us is that the professionals are highly committed to providing good care, to performing decent CPR and that they crave more feedback,” Robert O’Connor, MD, professor and chair of emergency medicine at the University of Virginia in Charlottesville, told Cardiology Today. “They really want objective information about their CPR performance according to guidelines and want real-time debriefing immediately after the case.”
Meaning of the survey results
According to the panelists, the survey results confirm attitudinal trends among health care professionals who frequently perform CPR, but the results also suggest that several areas regarding CPR performance, the importance of feedback and guideline adherence need to be studied.
“What this survey tells us is that people think they do a fairly good job performing CPR, and they think that CPR is really important. It tells us that they have heard the message from the last set of guidelines, and that message is that CPR is very important, that pauses in compression are bad,” Dana P. Edelson, MD, assistant professor of medicine and director of clinical research at the University of Chicago Medical Center, told Cardiology Today. “What it does not tell us is how these health care professionals actually do CPR. It does tell us that they want feedback and additional training.”
O’Connor agreed that the survey results are a useful indicator of attitudes regarding CPR but not a definitive data set and said that further study is needed to confirm its results.
“The survey does not translate into what is actually going on in the real world,” O’Connor said. “In other words, this is a survey of provider self-perception. In terms of whether providers are performing skills according to the CPR guidelines, it may be correct or it may not be.”
The CPR Improvement Group is comprised of representatives from Laerdal Medical, Philips Healthcare and Zoll Medical Corporation. – by Eric Raible