title: Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.
abstract: OBJECTIVE
  Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining.
  
  
  METHODS
  A CPR manikin creating a realistic relationship between chest compression depth and ABP was used for training/testing. Thirty-six ICU providers were randomized to brief, bedside ABP-directed CPR manikin skill retrainings: (1) Booster Plus (ABP visible during training and testing) versus (2) Booster Alone (ABP visible only during training, not testing) versus (3) control (testing, no intervention). Subjects completed skill tests pretraining (baseline), immediately after training (acquisition), and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of 100 mm Hg or higher and compression rate 100 to 120 per minute.
  
  
  RESULTS
  Overall, 14 of 24 (58%) participants acquired excellent CPR skills after their initial training (Booster Plus 75% vs 50% Booster Alone, P = 0.21). Adjusted for age, ABP-trained providers were 5.2× more likely to perform excellent CPR after the initial training (95% confidence interval [95% CI], 1.3-21.2; P = 0.02), and to retain these skills at 12 hours (adjusted odds ratio, 4.4; 95% CI, 1.3-14.9; P = 0.018) and 3 months (adjusted odds ratio, 4.1; 95% CI, 1.2-13.9; P = 0.023) when compared to baseline performance.
  
  
  CONCLUSIONS
  The ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.
authors.affiliation: From the Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Heather
authors.initials: H
authors.lastname: Wolfe
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Maltese
authors.forename: Dana E
authors.initials: DE
authors.lastname: Niles
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fischman
authors.forename: Veronika
authors.initials: V
authors.lastname: Legkobitova
authors.forename: Jessica
authors.initials: J
authors.lastname: Leffelman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Vinay M
authors.initials: VM
authors.lastname: Nadkarni
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sutton
mesh_terms: D000328:Adult; D001795:Blood Pressure Determination; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000592:standards*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008348:Manikins; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D055815:Young Adult
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