title: Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers.
abstract: OBJECTIVE
  To investigate the effectiveness of brief bedside cardiopulmonary resuscitation (CPR) training to improve the skill retention of hospital-based pediatric providers. We hypothesized that a low-dose, high-frequency training program (booster training) would improve CPR skill retention.
  
  
  METHODS
  CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated arrest. Basic life support-certified, hospital-based providers were randomly assigned to 1 of 4 study arms: (1) instructor-only training; (2) automated defibrillator feedback only; (3) instructor training combined with automated feedback; and (4) control (no structured training). Each session (time: 0, 1, 3, and 6 months after training) consisted of a pretraining evaluation (60 seconds), booster training (120 seconds), and a posttraining evaluation (60 seconds). Excellent CPR was defined as chest compression (CC) depth ≥ one-third anterior-posterior chest depth, rate ≥90 and ≤120 CC per minute, ≤20% of CCs with incomplete release (>2500 g), and no flow fraction ≤ 0.30.
  
  
  RESULTS
  Eighty-nine providers were randomly assigned; 74 (83%) completed all sessions. Retention of CPR skills was 2.3 times (95% confidence interval [CI]: 1.1-4.5; P=.02) more likely after 2 trainings and 2.9 times (95% CI: 1.4-6.2; P=.005) more likely after 3 trainings. The automated defibrillator feedback only group had lower retention rates compared with the instructor-only training group (odds ratio: 0.41 [95% CI: 0.17-0.97]; P = .043).
  
  
  CONCLUSIONS
  Brief bedside booster CPR training improves CPR skill retention. Our data reveal that instructor-led training improves retention compared with automated feedback training alone. Future studies should investigate whether bedside training improves CPR quality during actual pediatric arrests.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, 7th Floor, Central Wing 7C09 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. suttonr@email.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: D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D009741:Nursing Staff, Hospital / Q000193:education*; D011446:Prospective Studies