Research Article: Assessment of nurses’ cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana

Date Published: April 12, 2018

Publisher: AOSIS

Author(s): Lakshmi Rajeswaran, Megan Cox, Stoffel Moeng, Billy M. Tsima.


Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals.

We aimed to investigate nurses’ retention of CPR knowledge and skills at district hospitals in Botswana.

A quantitative, quasi-experimental study was conducted at three hospitals in Botswana. A pre-test, intervention, post-test, and a re-test after 6 months were utilised to determine the retention of CPR knowledge and skills. Non-probability, convenience sampling technique was used to select 154 nurses.

This study showed markedly deficient CPR knowledge and skills among registered nurses in the three district hospitals. The pre-test knowledge average score (48%) indicated that the nurses did not know the majority of the BLS steps. Only 85 nurses participated in the re-evaluation test at 6 months. While a 26.4% increase was observed in the immediate post-test score compared with the pre-test, the performance of the available participants dropped by 14.5% in the re-test 6 months after the post-test.

Poor CPR knowledge and skills among registered nurses may impede the survival and management of cardiac arrest victims. Employers and nursing professional bodies in Botswana should encourage and monitor regular CPR refresher courses.

Partial Text

Cardiopulmonary resuscitation (CPR) is a well-recognised medical procedure in which chest compressions and artificial ventilation are provided to maintain adequate blood flow to the brain and other vital organs.1 Cardiopulmonary resuscitation has been shown to reduce in-hospital cardiac death and related fatalities when patients are managed by adequately trained health care professionals.2 The American Heart Association (AHA) is the leading authority on resuscitation science. Its approved training courses are taught across the globe. In an effort to practise evidence-based medicine, AHA updates are released every 5 years. The 2015 AHA update for CPR and emergency cardiovascular care (ECC) focuses on topics involving significant new developments in resuscitation science or ongoing controversies, and serves as an update to the 2010 AHA Guidelines for CPR and ECC rather than as a complete revision of the guidelines.3

The study employed a quantitative design with the knowledge and skills response scored by the research team members. The study used a pre-test, intervention, a post-test and a re-test after 6 months design to determine the retention of CPR knowledge and skills among registered nurses. Same participants were assessed at baseline and at subsequent visits thus acting as their own study controls.

Of our study population of 154 nurses, the majority (70%) were female. Nearly 60% were aged between 20 and 30 years and 18% were aged over 40 years. Over 84% of the nurses were trained to diploma level (nursing or midwifery or both); graduate nurses represented 16%; and only one nurse had obtained a master’s qualification.

The findings of the study indicate that it is imperative for registered nurses to receive regular, periodic, in-service CPR courses as well as engage in regular CPR drills to update their knowledge and skills and to be aware of changes made in the latest guidelines in CPR science.




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