Facilitators and barriers for the implementation of resuscitation training programmes for schoolchildren

Abstract

BACKGROUNDTraining schoolchildren in resuscitation seems to improve rates of resuscitation by bystanders. Leading medical societies recommend comprehensive resuscitation education in schools. To date, no widespread implementation within the European Union has happened.OBJECTIVEThe study aim was to identify facilitators and barriers for the implementation of cardiopulmonary resuscitation training for schoolchildren within the European Union.DESIGNSystematic review.DATA SOURCESA literature search in PubMed was conducted between 1 January 1999 and 30 June 2020 in accordance with the PRISMA statement. The search terms ‘resuscitation’, ‘children’ and ‘Europe’ were combined with the Boolean Operator ‘AND’ and ‘OR’. Medical subject heading terms were used in order to include relevant articles.ELIGIBILITY CRITERIAArticles were included if cardiopulmonary resuscitation training specifically tailored for schoolchildren aged 12 to 18 years was considered in countries of the European Union. Articles that fulfilled the following criteria were excluded: duplicates, training methods only for specific patient groups, articles not accessible in the English language, and articles that did not include original data.Findings were structured by an evidence-based six-level approach to examine barriers and facilitators in healthcare.RESULTSThirty out of 2005 articles were identified. Large variations in cardiopulmonary resuscitation training approaches ranging from conventional to innovative training methods can be observed. Schoolteachers as resuscitation instructors act either as barrier or facilitator depending on their personal attitude and their exposure to training in resuscitation. Cardiopulmonary resuscitation training in schoolchildren is effective. The uncoordinated interplay between the generally motivated schools and the political orientation towards resuscitation training for schoolchildren serve as barrier. The lack of financial support, absent systematic organisation, and standardisation of training create major barriers.CONCLUSIONTraining schoolchildren in cardiopulmonary resuscitation is effective. More financial support and political guidance is needed. Until then, local initiatives, motivated teachers, and dedicated principles combined with innovative and low-cost training methods facilitate cardiopulmonary resuscitation training in schools.

Facilitators and Barriers Perceived by German Teachers Considering Basic Life Support Education in School—A Qualitative Study

“…In line with the identified challenges when implementing new approaches in schools [ 16 , 27 , 28 ], which have also been reported recently for the introduction of BLS lessons [ 11 , 12 , 13 , 29 ], a closer examination behind the curtains seems expedient. As usual in design research, and as postulated by Coburn [ 25 ], a qualitative analysis and dialogue with practitioners is the method-of-choice to differentiate the content of existing quantitative findings and add in-depth information.…”

“…This personal uncertainty, if cumulating with other factors in schools, federal and local curricula, or insufficient infrastructure, may lead to a limited capacity for the development of local BLS programs at schools. Since several quantitative investigations showed general categories of inhibitory issues—equipment, teacher training or no obligatory guidelines, for instance [ 11 , 13 , 14 ]—qualitative in-depth investigations of the teachers’ motives, concerns, thoughts and recommendations are rare.…”

Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis

“…Using a peer trainer method may help facilitate implementation of CPR training programs in schools, as schoolteacher’s willingness to teach, is often tied to their own perceived CPR proficiency level. 14 Additionally, it may be more cost effective and sustainable than hiring certified instructors, which are often cited as a major barrier for schools. 127…”

“… 12 This can help to facilitate the development of practical skills, as they become more capable of performing physical maneuvers and make them more likely to help in emergency situations as adults. 13 , 14 …”

“…As there are many barriers to implementing CPR training in schools, 14 investigating whether innovative training modalities (i.e. nonpractical, self- or peer-based training), are as effective as traditional, instructor-led methods, could provide guidance as to whether these strategies can be used to increase implementation of CPR training in schools.…”