Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial

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School of Nursing Departmental Papers
Degree type
Discipline
Subject
Adult
Aged
Cardiopulmonary Resuscitation
Death, Sudden, Cardiac
Educational Status
Family
Female
Health Education
Health Knowledge, Attitudes, Practice
Heart Arrest
Humans
Male
Manikins
Middle Aged
Pennsylvania
Prospective Studies
Retention (Psychology)
Risk Assessment
Risk Factors
Time Factors
Video Recording
Adult
Aged
Cardiopulmonary Resuscitation
Death
Sudden
Cardiac
Educational Status
Family
Female
Health Education
Health Knowledge
Attitudes
Practice
Heart Arrest
Humans
Male
Manikins
Middle Aged
Pennsylvania
Prospective Studies
Retention (Psychology)
Risk Assessment
Risk Factors
Time Factors
Video Recording
Cardiology
Cardiovascular Diseases
Circulatory and Respiratory Physiology
Emergency Medicine
Health and Medical Administration
Health Information Technology
Medicine and Health Sciences
Nursing
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Blewer, Audrey L
Putt, Mary E
Becker, Lance B
Li, Jiaqi
Leary, Marion
Shea, Judy A
Kirkpatrick, James N
Berg, Robert A
Nadkarni, Vinay M
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Abstract

BACKGROUND: Cardiopulmonary resuscitation (CPR) training rates in the United States are low, highlighting the need to develop CPR educational approaches that are simpler, with broader dissemination potential. The minimum training required to ensure long-term skill retention remains poorly characterized. We compared CPR skill retention among laypersons randomized to training with video-only (VO; no manikin) with those trained with a video self-instruction kit (VSI; with manikin). We hypothesized that VO training would be noninferior to the VSI approach with respect to chest compression (CC) rate. METHODS AND RESULTS: We performed a prospective, cluster randomized trial of CPR education for family members of patients with high-risk cardiac conditions on hospital cardiac units, using a multicenter pragmatic design. Eight hospitals were randomized to offer either VO or VSI training before discharge using volunteer trainers. CPR skills were assessed 6 months post training. Mean CC rate among those trained with VO compared with those trained with VSI was assessed with a noninferiority margin set at 8 CC per min; as a secondary outcome, mean differences in CC depth were assessed. From February 2012 to May 2015, 1464 subjects were enrolled and 522 subjects completed a skills assessment. The mean CC rates were 87.7 (VO) CC per min and 89.3 (VSI) CC per min; we concluded noninferiority for VO based on a mean difference of -1.6 (90% confidence interval, -5.2 to 2.1). The mean CC depth was 40.2 mm (VO) and 45.8 mm (VSI) with a mean difference of -5.6 (95% confidence interval, -7.6 to -3.7). Results were similar after multivariate regression adjustment. CONCLUSIONS: In this large, prospective trial of CPR skill retention, VO training yielded a noninferior difference in CC rate compared with VSI training. CC depth was greater in the VSI group. These findings suggest a potential trade-off in efforts for broad dissemination of basic CPR skills; VO training might allow for greater scalability and dissemination, but with a potential reduction in CC depth. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01514656.

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2016-10-04
Journal title
Circulation: Cardiovascular Quality and Outcomes
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