Resuscitation in Community Healthcare Facilities in Israel

Abstract

Background: Out-of-hospital cardiac-arrest (OHCA) is a major public health challenge. Community health care providers (CHP) may play an important role through early identification, basic life support and defibrillation. Few studies have evaluated the incidence and characteristics of OHCAs initially cared for by CHP, most finding improved survival. This study combined CHP treated OHCA case analysis, with assessment of provider resuscitation preparedness. Methods: An analysis of all CHP initiated resuscitations in a large Health Maintenance Organization (HMO) reported over 42 months, coupled with an online survey assessing CHP resuscitation knowledge, experience, training and self-confidence. Results: 22 resuscitations met inclusion criteria. In 21 CHP initiated chest-compressions but in only 8 cases they utilized the clinic’s automated external defibrillator (AED) prior to emergency medical services (EMS) arrival. There were 275 providers surveyed. Of the surveyed providers, 89.4% reported previous basic life support (BLS)/advanced cardiovascular life support (ALS) training, 67.9% within the last three years. Previous resuscitation experience was reported by 72.7%. The lowest scoring knowledge question was on indications for AED application −56.3%. Additionally, 44.4% reported low confidence in their resuscitation skills. CHP with previous cardiopulmonary resuscitation (CPR) experience reported higher confidence. Longer time since last CPR training lowered self-confidence. Conclusions: Early AED application is crucial for patients with OHCA. All clinics in our study were equipped with AED’s and most CHP received training in their use, but remained insecure regarding their use, often failing to do so.

Knowledge and opinions of nursing undergraduate students about basic life support measures

“…Osim toga, velik utjecaj na uhodanost prilikom provođenja navedenih postupaka ima i radno mjesto te učestalost susretanja s hitnim stanjima sličnog tipa. Pokazalo se da dugotrajni rad u okruženju primarne zdravstvene zaštite i neizlaganje hitnim slučajevima koji zahtijevaju nečije znanje i vještinu u kardiopulmonalnoj reanimaciji utječe na njezinu izvedbu [9]. Druge su studije otkrile i potvrdile da se znanje i vještine zdravstvenih djelatnika značajno pogoršavaju ako dulje vrijeme nisu provodili kardiopulmonalnu reanimaciju.…”

“…In addition, the place of work and the frequency of encountering emergencies of a similar type greatly influence the familiarity with the implementation of the mentioned procedures. It has been shown that long-term work in a primary care environment and not being exposed to emergency cases that require one's knowledge and skill in cardiopulmonary resuscitation affect its performance [9]. Other studies have found and confirmed that the knowledge and skills of healthcare providers deteriorate significantly when they have not performed cardiopulmonary resuscitation over an extended period of time.…”

Development and Validation of Questionnaire for Knowledge, Attitudes and Self-Efficacy on Adult Cardiopulmonary Resuscitation Among Healthcare Providers

“…A study showed that CPR skills decline three months after certification (11,12). Healthcare providers not often exposed to situations that necessitate them to perform CPR, especially those who work for a long time in remote facilities, will affect their adult CPR performance (7,13).…”