title: "Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.
abstract: OBJECTIVE
  To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers.
  
  
  METHODS
  Prospective, randomized trial.
  
  
  METHODS
  General pediatric wards at Children's Hospital of Philadelphia.
  
  
  METHODS
  Sixty-nine Basic Life Support-certified hospital-based providers.
  
  
  METHODS
  CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback.
  
  
  RESULTS
  Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and <120 min(-1)); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]).
  
  
  CONCLUSIONS
  Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. suttonr@chop.edu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sutton
authors.forename: Dana
authors.initials: D
authors.lastname: Niles
authors.forename: Peter A
authors.initials: PA
authors.lastname: Meaney
authors.forename: Richard
authors.initials: R
authors.lastname: Aplenc
authors.forename: Benjamin
authors.initials: B
authors.lastname: French
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Abella
authors.forename: Evelyn L
authors.initials: EL
authors.lastname: Lengetti
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Mark A
authors.initials: MA
authors.lastname: Helfaer
authors.forename: Vinay
authors.initials: V
authors.lastname: Nadkarni
mesh_terms: D000328:Adult; D001331:Automation; D016887:Cardiopulmonary Resuscitation; D002983:Clinical Competence; D047548:Defibrillators; D005246:Feedback; D005260:Female; D019983:Guideline Adherence; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007318:Inservice Training; D008297:Male; D010372:Pediatrics; D015397:Program Evaluation; D011446:Prospective Studies; D011787:Quality of Health Care; D055815:Young Adult