Health Care Providers’ Knowledge, Skills and Institutional Factors that Determine Effective Cardiopulmonary Resuscitation at Nakuru County Hospital

Abstract

Cardio Pulmonary Resuscitation refers to a sequential chain of measures taken to save and maintain the quality of life of a patient following cardiac arrest. The process involves recognition of absent breathing and circulation, basic life support with chest compressions and rescue breathing, and post resuscitative care. Effective cardiopulmonary resuscitation improves the patients’ outcomes hence reducing mortality related to cardiac arrest. The determinants of effective cardiopulmonary resuscitation (CPR) among health care workers are not well researched in African countries. The study sought to examine the knowledge, skills, and institutional factors that determine effective cardiopulmonary resuscitation among health care providers at Nakuru County hospital. The study adopted an analytic cross-sectional design; incorporated quantitative study tools. The study was carried out at Nakuru County Hospital. A census sampling technique was adopted to select 175 respondents who participated in the study. Data was collected using questionnaires and checklists. Data analysis was done using SPSS computer software, version 24 for descriptive analysis to generate frequencies, percentages, and tabulations. Chi-square tests and multiple regression analysis were done to determine the significant association between variables. Ethical approval was obtained from National Commission for Science, Technology, and Innovation (NACOSTI). Permission to collect data was also sought from Nakuru County Hospital administration. Informed consent was sought from the respondents before data was obtained. Majority, 54.3% (n=88) of the respondents had low knowledge of cardiopulmonary resuscitation. The majority 70.9% (n=112) did not have a BLS/ACLS certificate. According to the findings, 55.1% (n=87) and 51.9% (N=81) indicated that they did not have all the necessary resources for CPR. There was a significant relationship (p<0.001) between CPR knowledge and CPR practice. Among institutional factors, having a BLS/ACLS certificate (p=0.003), a refresher course in the last 2 years (p<0.001) and necessary resources (p=0.014) were significant. Respondents who had a BLS/ACLS certificate and those who had a refresher course in the last 2 years and those who indicated that necessary resources were 3.4, 2.9, and 3.1 times more likely to have good CPR practice. The poor practice of cardiopulmonary resuscitation among health care workers at Nakuru County Hospital is attributable to low CPR knowledge. Institutional factors also influenced effective CPR. More emphasis should be placed on continuous professional development and supervision be done after training. The hospital managers to enact a policy ensuring all health care workers possess a valid BLS/ACLS certificate.