"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.
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.
Sutton
Robert M
RM
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA. suttonr@chop.edu
Niles
Dana
D
Meaney
Peter A
PA
Aplenc
Richard
R
French
Benjamin
B
Abella
Benjamin S
BS
Lengetti
Evelyn L
EL
Berg
Robert A
RA
Helfaer
Mark A
MA
Nadkarni
Vinay
V
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