Research Project Instructions

Steps for participation in the Less Stress Instructional Services CPR retention study:

Step 1: Read the following script to your participants: "The training center I'm affiliated with is conducting research on how well CPR is retained from course to course. Your participation would be welcome in this project. It involves you filling out a questionnaire and performing 2 minutes of CPR on video. You do not have to participate and your participation will not affect your recertification course in any way. If you are interested please sign the consent form and I will provide you with a questionnaire. " Step 2: Number your documents None of the documents will end up with the student's name to protect their identities. You will need to generate an ID number for them by entering the MMDD of your class, followed by your initials and finally a XX numeric sequence starting with 01. For example, if instructor John Doe was doing a class on 01/15/15, the numbers would be: First student: 0115-JD-01 Second student: 0115-JD-02 Third student: 0115-JD-03 Be sure to write this number on the student's questionnaire and state that number in the first few seconds of your video of the student's performance. Step 3: Collect your survey Give the student the questionnaire and ask him/her to fill it out. Please do not steer the student towards any answers of explain the questions. If they have questions, simply tell them you do not want to steer their answers and that they should simply answer the question as best they can. Collect the form and insure the ID number is present and all answers are completed. Step 4: Shoot your footage Set up an adult manikin with a pocket mask adjacent to it. Have an AED trainer nearby but not adjacent to the manikin. Read this prepared script to the student: "This exercise will involve you treating an adult CPR patient. The patient collapsed suddenly in a supermarket and you are nearby with a pocket mask. When we start I would like you to treat this patient EXACTLY as you would treat a patient. It is critical that you perform this skill in the precise way you trained in the last course, including performing compressions to the real depths, assessing the patient for the real time frames, and performing all the steps on the manikin without simulating them. You can ask a bystander to call 9-1-1 and get an AED for you. If you assess the patient and see no breathing assume the patient has no breathing. If you do not feel a pulse, assume the patient has no pulse. I cannot answer questions or 'freeze time' for you, so please simply perform the skill in real time as best you can. Are you ready to start?" The point of the research is to assess their residual skills - do not answer any questions about CPR skills before the video is taken. Start the video, say the student's ID number clearly into the video, then ask the student to begin.

Framing the camera for the video footage:

Head visible for mask technique. Student takes this position to use BVM after AED use

Set up your mobile phone or camera in this fashion:

Chest easily seen for compressions and chest rise

AED placement locations visible

State the student's ID and have him/her begin the skill. Have he/she assess the patient and being CPR. Once the student has performed two cycles of compressions and breaths, inform him/her the AED, bag-mask, and a second rescuer has arrived at the scene. Allow the student to utilize the AED , then have your second student hand the Bag-Mask to the first student and immediately perform chest compressions. The first/original student should perform bag-mask breaths for two cycles. Once the 2 breaths of the second set are delivered, the scenario is over. To review:

Student assesses responsiveness, calls for help, checks for pulse

Performs 30:2 CPR with a pocket mask x 2 cycles

Second rescuer arrives with AED and bag-mask

Attaches and utilizes AED

Hands BVM to student and begins 30 compressions

Performs 2 BVM breaths

Performs 30 compressions

Performs 2 BVM breaths

SCENARIO IS OVER AT THIS POINT

COMPARISON OF PERCEIVED AND DEMONSTRATED COMPETENCY

Appendix I

Student ID:

CPR Retention Survey Form Thank you for consenting to participate in research regarding CPR skills retention. Please complete the following questions on this survey then fold and hand this paper to the trainer. Results are confidential and are not used in your recertification course in any way. Please described your healthcare licensure and experience (please check all that apply): License Held Yrs of Experience Practice Environment (MedSurg, ER, School RN, etc) □ Registered Nurse _____ _____________________ □ Practical Nurse _____ _____________________ □ EMT _____ _____________________ □ Paramedic _____ _____________________ □ Physician _____ _____________________ □ Fire/Police _____ _____________________ □ Therapist (RT/PT/OT) _____ _____________________ □ Technician / Care Associate _____ _____________________ □ Other: ______________________ _____ _____________________

1. How comfortable are you overall with your BLS skills:

2. With the appropriate equipment how confident would you be managing a cardiac arrest patient by yourself for 2 minutes? □ Very Comfortable

□ Very Comfortable □ Somewhat Comfortable □ Somewhat Uncomfortable □ Very Uncomfortable

□ Somewhat Comfortable □ Somewhat Uncomfortable □ Very Uncomfortable

3. How would you assess your chest compression skills?

4. How would you assess your skill at rescue breathing with a bag-mask device?

□ Excellent □ Good □ Marginal □ Poor

□ Excellent □ Good □ Marginal □ Poor

5. How would you assess your ability to efficiently and safely use an Automated External Defibrillator (AED)?

6. How would you assess your ability to organize and execute all the individual skills used in resuscitation?

□ Excellent □ Good □ Marginal □ Poor

□ Excellent □ Good □ Marginal □ Poor

Student ID:

Appendix II

COMPARISON OF PERCEIVED AND DEMONSTRATED COMPETENCY Adult 1-Rescuer and 2-Rescuer CPR / AED Skills Test

Skill Step

Critical Performance Steps

if done correctly

Points

1

ASSESSES: Checks for response and for no breathing or no normal breathing, only gasping (at least 5 seconds but no more than 10 seconds

1

2 3 4

ACTIVATES emergency responses system Checks for PULSE (no more than 10 seconds) GIVES HIGH-QUALITY CPR: Correct compression HAND PLACEMENT

1

1**

4a

1 1

ADEQUATE DEPTH: Delivers compressions at least 2” in depth (at least 23 out of 30) 4b ADEQUATE RATE: At least 100/min (ie, delivers each set of 30 chest compressions in 18 seconds or less) 4c ALLOWS COMPLETE CHEST RECOIL (at least 23 out of 30) MINIMIZES INTERRUPTIONS: Gives 2 breaths with pocket mask in less than 10 seconds 4d 4f

Time

1

1 1

AED Skills Evaluation and SWITCH During this next phase, evaluate the rescuer’s ability to use the AED while another rescuer performs chest compressions. Second rescuer arrives with AED and bag-mask device and begins compressions

5 6 7 8

First Rescuer turns on the AED

1 1 1 1

First rescuer applies the AED to the correct locations First rescuer clears victim, allowing AED to analyze

If AED indicates shockable rhythm, first rescuer clears victim again and delivers shock

First Rescuer Bag-Mask Ventilation During this next phase, evaluate the first rescuer’s ability to give breaths

9

Both rescuers RESUME HIGH-QUALITY CPR immediately after shock delivery: SECOND RESCUER gives 30 compressions immediately after shock delivery (for 2 cycles) FIRST RESCUER successfully delivers 2 breaths with bag-mask (for 2 cycles)

9a

1

9b

1

1

Points:

15 Total Points Possible