Haider Alaa

Journal Healthcare Treatment Development
ISSN: 2799-1148
Vol: 04, No. 03, April-May 2024
http://journal.hmjournals.com/index.php/JHTD
DOI: https://doi.org/10.55529/jhtd.43.24.33
Evaluation of Nurses' Competence in Cardiopulmonary

Resuscitation at AL-Diwaniyah Teaching Hospital
Haider Kadhum Raddam1*, Alaa Ebrahim Saeed2

1*
Assistant Lecturer in the Department of Community Health Nursing at the Faculty of
Nursing, University of Al-Qadisiyah, located in Al-Diwaniyah, Qadisiyah, Iraq.
2
Adult Nursing Department, College of Nursing, University of Al- Qadisiya, Iraq.
Corresponding Email: 1*haider.kadhum@qu.edu.iq
Received: 28 January 2024 Accepted: 15 April 2024 Published: 29 May 2024
Abstract: Background: Cardiopulmonary resuscitation (CPR) is a widely acknowledged

medical method that involves applying chest compressions and artificial ventilation to ensure
sufficient blood circulation to the brain and other vital organs.
Approach: An observational study was carried out at Al-Diwaniyah Teaching Hospital
between October 15, 2023, and March 30, 2024. A non-probability cross-sectional sample
was selected from 50 nurses in the cardiac care, intensive care, emergency, and pulmonary
resuscitation units. Information was collected by preparing a questionnaire. It was built for
the study, and data was collected through a personal interview. The questionnaire consisted
of two parts; the first part included 7. Paragraphs and the second part contain 25
paragraphs. Information was collected using a personal interview method for the study
sample, and its credibility was determined by presenting it to 10 experts.
Results: The results of the study indicated that the majority of nurses have little knowledge
about cardiac arrest and cardiopulmonary resuscitation. The cognitive weakness of the
nursing staff does not affect gender and age, nor does it affect the number of years of service,
place of work, training, and efficiency of cardiac resuscitation. Still, there is a relationship
between their knowledge and academic qualification.
Recommendations: he emphasized the necessity of involving nurses in scientific
rehabilitation courses related to cardiac resuscitation. It is necessary to conduct field
research to stop this problem and stimulate nursing creativity in this field.
Keywords: Evaluation, Cardiopulmonary Resuscitation, Nurses Knowledge, AL-Diwaniyah

Teaching Hospital.
1. INTRODUCTION
It is risky to experience sudden cardiac arrest. danger to life, prompt action in order to prevent
Sudden Cardiac Death, medical intervention is essential (Erickson et al., 2021; Zimmerman &
Copyright The Author(s) 2024.This is an Open Access Article distributed under the CC BY
license. (http://creativecommons.org/licenses/by/4.0/) 24
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Tan, 2021). Access to timely and sufficient medical care can rise dramatically Probabilities of
surviving (Harmon, 2022). A sudden cardiac arrest is It can be broadly divided into two
categories: hospital and non-hospital accidents (Marijon et al., 2023). Out-of-hospital adult
cardiac arrest is thought to occur in 95.9 cases per 100,000 persons per year (Rodríguez-Reyes
et al., 2020). a variety of techniques that save lives referred to as CPR (cardiopulmonary
rescue). It is employed in contemporary medicine to raise the survival rates of the central
nervous system (Rajagopalan et al., 2022). According to a Great West survey40.7% of people
in a Turkish city reside in a high area. According to the educated district, 3.6% of them have
performed CPR on bystanders and have handled peripheral cardiopulmonary resuscitation
(Batelaan et al., 2021). This demands community. Recognizing the signs of cardiac arrest and
knowing when to provide CPR. early identification and treatment of cardiac arrest situations
Life (Held et al., 2022). Probabilities of surviving It drops from 7 to 10% in cardiac arrest cases
for every minute that CPR is delayed (Kaihula et al 2018). Additionally, it may reduce the
amount of time needed for their hospital stay to end (Cone et al., 2020). Identification Heart-
lung arrest has an inverse relationship Cardiopulmonary resuscitation takes a long time because
of the interval between starting active resuscitation and training the medical personnel who will
be caring for the patient. It has been made simple enough for anyone to grasp. is capable of
learning, irrespective of prior medical education (Rodríguez-Reyes et al., 2020). This swiftly
equips trained medical staff Start this treatment now to save lives (Harris and Lubitz, 2020).
Previous CPR instruction only available to medical professionals. It was later discovered that
a large number of these occurrences occurred outside of medical facilities and that early cardiac
resuscitation was required for the witness who saw the incidence. As a result, CPR is regarded
as a skill that is applicable to everyone (Holmstrom et al., 2023).
2. RELATED WORKS
Rajeswaran and colleagues conducted a study examining the capacity of nurses to sustain their
CPR knowledge and abilities in district hospitals in Botswana. The findings of this study
demonstrate a notable deficiency in the knowledge and abilities of registered nurses when it
comes to performing CPR at three local hospitals. The nurses' mean pre-test knowledge score
of 48% suggested a significant lack of familiarity with the bulk of basic life support (BLS)
activities. Following a duration of 6 months, a collective sum of 85 nurses actively engaged in
the process of reassessment screening. The direct post-test score had a substantial increase of
26.4% in comparison to the pre-test. Nevertheless, the performance of individuals who
participated in the follow-up assessment 6 months later shown a 14.5% decrease. Conclusion:
Insufficient skill and expertise in cardiopulmonary resuscitation (CPR) among registered
nurses can impede their capacity to rescue and administer adequate care to those undergoing
cardiac arrest. (Rajeswaran, 2018) suggests that employers and nursing professional bodies in
Botswana should promote and oversee frequent CPR refresher training. A study was conducted
by Ahmed and colleagues to assess the proficiency of nurses in cardiopulmonary resuscitation
(CPR) and examine the correlation between their knowledge and demographic factors such as
gender, age group, academic qualifications, years of work experience, and formal training. The
findings indicated that a significant proportion of nurses demonstrated inadequate
comprehension of cardiopulmonary resuscitation. There is a strong correlation between the
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nurse's knowledge and academic degrees, as evidenced by the p value of 0.05. Nevertheless,
there is no discernible association between a nurse's expertise and their gender, age bracket,
years of professional experience, or formal education. In conclusion, the researcher determined
that the majority of the participants in the study were female. Furthermore, a significant
proportion of the study participants demonstrated a restricted comprehension of CPR, as shown
by an average score of 0.44.and the recommendation includes Carry out a study on
cardiopulmonary resuscitation (CPR) training programs utilizing a more extensive sample size
in order to accurately assess the influence of CPR training on nurses' comprehension of CPR.
Key concepts: evaluation, expertise, healthcare professionals, cardiopulmonary resuscitation
(Ahmed, 2020).
3. METHODOLOGY
Design of the Study: A cross-sectional study with a descriptive design was done at AL-
Diwaniyah Teaching Hospital from October 15, 2023, to March 30, 2024. To evaluate the
nurses' understanding of cardiopulmonary resuscitation.
Setting of the Study: The present investigation was carried out at the AL-Diwaniyah Teaching
Hospital in the city of AL-Diwaniyah.
The Sample of the Study: A purposive sample of 50 nurses working in the coronary care unit,
which includes the intensive care unit, emergency unit, and respiratory care unit, at AL-
Diwaniyah Teaching Hospital.
The Study Instrument: The researcher developed and prepared questionnaires to assess the
level of knowledge that nurses possess regarding cardiopulmonary resuscitation. The
researcher utilized an exploratory study approach to develop the questionnaires. Open-ended
questions were administered to a sample of 50 nurses, who were selected based on specific
criteria outlined in the study. The questionnaires were designed and included of three sections.
The first portion, Demographic Characteristics, comprised seven items: gender, age, academic
achievement, years of work experience, present place of work, and whether the individual has
received any training course on CPR. Do you administer cardiopulmonary resuscitation (CPR)
to the patient? The section on nurses' understanding of cardiopulmonary resuscitation included
of 11 questions pertaining to anatomy and physiology, as well as 14 questions related to cardiac
arrest and cardiopulmonary resuscitation.
Method of Data Collection: The data were gathered using the prepared questionnaires and a
structured self-report technique with the participants. Data collection occurred between
December 7th, 2023 and January 7th, 2024. Each subject allocates an average of 15 to 20
minutes.
Reliability of the Questionnaire: The internal consistency of the questionnaire was assessed
by calculating the Cronbach's alpha score, which is a measure of reliability. The range of values
obtained was between 0.7 and 0.9. The estimated findings indicate that the internal consistency,
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as measured by Cronbach's Alpha, scored 0.812. The data acquired from the questionnaire
study demonstrated a good internal consistency of replies. This indicates that the designed
questionnaire is valid for studying the phenomenon in the same population at any future time.
Data Analysis: The data was analyzed using SPSS Version 25. Two distinct methodologies
are employed for data analysis, namely descriptive analysis, which includes frequency and
percentage calculations, and inferential analysis, namely the Chi-square test of independence.
4. RESULTS AND DISCUSSION
Table 1: The demographic characteristics of the participants

Demographic characteristics Frequency Percent
18- 22 6 12.0
23 - 28 38 76.0
29 - 34 3 6.0
Age 35 - 40 1 2.0
41 and more 2 4.0
Total 50 100.0
Mean ± SD 26.34 ± 4.35
Male 19 38.0
Gender Female 31 62.0
Total 50 100.0
High school of Nursing 2 4.0
institute of Nursing 21 42.0
Level of
College of Nursing 24 48.0
Education
High study in Nursing 3 6.0
Total 50 100.0
One year or less 16 32.0
2 – 5 years 27 54.0
Experience
6- 10 year 4 8.0
years
11.00 year and more 3 6.0
Mean ± SD 3.66 ± 4.4
CCU 19 38.0
ICU 11 22.0
Emergency department 12 24.0
Working place
RCU 5 10.0
Another department 3 6.0
Total 50 100.0
No 35 70.0
CPR training
Yes 15 30.0
course
Total 50 100.0
Practice CPR Daily 9 18.0
for the patient Weekly 20 40.0
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Monthly 13 26.0
Annually 8 16.0
Total 50 100.0
This table shows the demographic characteristics of the participants. The nurses aged 23 to 28
years had the highest percentage (76%), while the lowest was between 35 and 40 years.
Females were 62%. Nursing with a bachelor's degree appeared in 48% of them, compared with
those who had a high school degree in 4%. There were a lot of them working in the cardiac
care unit (CCU), and they not have any training course about CPR with 70% of them.
Table 2: The overall level of knowledge of participants

No. Questions False answers True answers
Heart anatomy and physiology f % f %
1. The heart is a hollow muscular organ located 12 24 38 76
in…
2. The weight and size of the heart are affected 48 96 2 4
by…
3. The heart pumps blood to the tissues, to provide 28 56 22 44
them with?
4. How many layers make up the heart? 23 46 27 54
5. Right side of the heart….? 20 40 30 60
6. Left side of the heart….? 29 58 21 42
7. Heart valves allow blood to flow in one 19 38 31 62
direction...?
8. Cardiac output is…? 35 70 15 30
9. The amount of blood expelled from the heart 48 96 2 4
during each beat...?
10. Where is the respiratory center located? 32 64 18 36
11. Lungs is…...? 24 48 26 52
CPR and heart attack f % f %
12. Which of the following medical conditions 10 20 40 80
would lead to CPR?
13. What are the most common complications for a 34 68 16 32
patient undergoing CPR?
14. Which of the following interventions has a 47 94 3 6
significant impact on improving survival during
sudden cardiac arrest?
15. What is the most likely cause of cardiac arrest 40 80 10 20
after myocardial infarction?
16. A patient who has a cardiac arrest should have 31 62 19 38
the following signs?
17. The first organ in the human body affected by 30 60 20 40
lack of oxygen is?
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18. Cardiac arrest occurs…? 30 60 20 40

19. How long can the brain survive without oxygen? 41 82 9 18
20. The first and necessary step in treating a cardiac 8 16 42 84
arrest is immediate recognition. The paramedic
should..
21. When assessing the pulse of an unconscious 16 32 34 68
patient, which of the following is the best artery
to check the pulse?
22. How often should an emergency vehicle be 37 74 13 26
checked in the lobby or anywhere in a hospital?
23. What is the first medication given in cases of 13 26 37 74
cardiac arrest?
24. What does the abbreviation CPR mean to you? 6 12 44 88
25. (Survival of chain the) means…? 21 42 29 58
Table 3: shows the overall level of knowledge of the participants.

Frequency Percent
Low 9 18.0
Knowledge Fair 41 82.0
Good 0 0
This table shows the overall level of knowledge of the participants. The greatest percentage
had a fair level of knowledge, while there isn't anyone who has good knowledge.
Table 4: the relationship between demographic variables and overall knowledge

Demographic variables Chi-square test value df P-value Sig.
Age 1.148 4 .887 N.S.
Gender .101 1 1.000 N.S.
Level of Education 2.373 3 .499 N.S.
Experience years 10.777 3 .013 Sig.
Working place 1.371 4 .849 N.S.
CPR training course 4.704 1 .043 Sig.
Practice CPR for the patient 2.965 3 .397 N.S.
This table shows the relationship between demographic variables and overall knowledge.
"Experience year" and "CPR training courses" had a significant relationship between them and
overall knowledge because their p-value was greater than the significant 0.05. Other variables
didn't have a relationship because their p-values were greater than 0.05.
Discussion
Part 1: Examining the Demographic Factors Associated with Nursing Knowledge The study's
findings, which indicate that 62% of nurses were female, are corroborated by Mahaling (2015)
research, which also indicated that most nurses were female. The age group of nurses with the
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biggest proportion (76%) consisted of individuals aged 23 to 28. The age group with the lowest
prevalence (2%) was comprised of those aged 35 to 40. This can be attributed to the younger
nurses recently graduating, since they tend to be more driven, engaged, and active compared
to their older counterparts in the region. This result is similar to the one obtained by Winkelman
et al. (2009). The study's findings suggest that a substantial percentage of the surveyed nurses
were between the age bracket of 23 to 28. Regarding educational achievement, 48% of the
participants in the survey, who were nurses, possessed a bachelor's degree from a nursing
college. This outcome concurs with Wendel (2011) discovery that the majority of study
participants were bachelor's degree-holding nurses. The study sample included nurses with a
diploma from an institute of nursing, and their percentage was higher than that of nurses with
other education levels. However, it was still less than the 42% of nurses who had bachelor's
degrees. More studies, or 54% of all studies, had between two and five years of work
experience. This result bears a striking resemblance to Mohammed (2014), and Wendel (2011).
According to their findings, the majority of nurses had less than five years of experience. A
higher percentage of study samples (38%) from the cardiac care unit (CCU) are shown in the
working workplace. Mohammed al-janbi (2014) demonstrates that a greater the percentage
pertained to nurses who did not partake in training courses. Regarding the sample used in the
study, the majority (70%) had not attended any cardiopulmonary resuscitation training classes.
According to the current study, 40% of nurses who perform weekly cardiopulmonary
resuscitation on patients are accounted for. Compared to individuals who perform
cardiopulmonary resuscitation on a daily and monthly basis, their percentage is higher. This
conclusion conflicts with that of Mohammed's (2014) study, which found that 22.4% of nurses
were unable to perform (CPR).
Part 2: Examination of the ultimate evaluation nurses' proficiency in CPR: The examination of
the nurse's knowledge related cardiac arrest and cardiopulmonary resuscitation yielded a
moderate level of knowledge. The findings of this study were consistent with those of
Mohammed (2014), who conducted a similar assessment of nurses' knowledge of CPR at Al-
Najef Teaching Hospital. Both studies revealed a low level of understanding among the nurses.
At Al-Diwaniyah Teaching City Hospital, there is a lack of nurses that possess proficient
knowledge in CPR. This outcome paralleled the investigation conducted on house officers,
which examined their acquisition of teaching knowledge, perceptions Regarding the
proficiency in performing CPR, it encompasses a range of abilities and the individual's level of
self-assurance. The study conducted by Saiboon et al. (2007) investigated the perceived
competence. of healthcare professionals in Kuwait in terms of their knowledge and practice of
cardiopulmonary resuscitation (CPR). However, both studies concluded that nurses' knowledge
of cardiac arrest and CPR procedures is inadequate.
Part 3: Examination of the relationship between general evaluation expertise and demographic
factors: The study found There is no discernible association between the nurse's understanding
of Cardiopulmonary resuscitation (CPR) protocols and their age., with a p-value of 0.05. This
finding is consistent with previous research by Mohammed (2014) and Hamza (2012) likewise
found no significant association between the nurse's knowledge and their age. The study found
no statistically significant correlation between the nurse's knowledge ratings regarding
cardiopulmonary resuscitation and their gender, as indicated by a p-value of 0.05. The research
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conducted by Mohammed (2014) and Rajeswaran (2009) provides evidence that there is no
substantial link between a nurse's proficiency in cardiopulmonary resuscitation and their
gender. No statistically significant link was observed between the nurse's CPR knowledge and
their level of education at the specified p-value. This discovery presents a contradiction to the
findings of Mohammed's (2014) research, which established a There is a strong correlation
between nurses' understanding of cardiopulmonary resuscitation and their amount of education.
An evident correlation was observed between the nurse's proficiency in cardiopulmonary
resuscitation and their duration of professional experience., with a p-value of 0.05. confirmed
this discovery by demonstrating a significant association between nurses' understanding of
cardiopulmonary resuscitation and their duration of work experience. The study found no
significant correlation between the nurse's understanding of cardiopulmonary resuscitation
(CPR) and their workplace or their application of CPR for the patient, as indicated by a p-value
of 0.05. This discovery was confirmed by Mohammed (2014). Their findings The data suggests
that there was no significant correlation between the nurses' understanding of cardiopulmonary
resuscitation and their job environment or their execution of cardiopulmonary resuscitation on
patients. An evident link was established between the nurse's understanding of
cardiopulmonary resuscitation and their training course, as evidenced by a p-value of 0.05. This
discovery is in direct opposition to the findings of Mohammed (2014). Their findings indicate
that there is no substantial association between the level of cardiopulmonary resuscitation
knowledge among nurses and the specific training program they have completed.
5. CONCLUSION AND RECOMMENDATIONS
1. More of the studied nurses have bachelor's academic qualifications and diplomas,
However, the percentage of nurses who hold a diploma is less than the percentage of
bachelor’s degrees.
2. The majority of the samples lack training courses in cardiopulmonary resuscitation.
3. The majority of study nurses provide CPR to their patients on a weekly basis.
4. The majority of the study nurses possess a moderate level of understanding in
cardiopulmonary resuscitation.
5. The referral institutions should provide procedure manuals that contain comprehensive
information regarding the latest advancements, discoveries, and practices in CPR. An
annual audit should be conducted on the procedure handbook, and immediate action should
be taken to address any detected problems.
6. Implementation of CPR training for nursing students in nursing colleges and institutes.
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Journal Healthcare Treatment Development

Evaluation of Nurses' Competence in Cardiopulmonary

Haider Kadhum Raddam1*, Alaa Ebrahim Saeed2

Corresponding Email: 1*haider.kadhum@qu.edu.iq

Received: 28 January 2024 Accepted: 15 April 2024 Published: 29 May 2024

Abstract: Background: Cardiopulmonary resuscitation (CPR) is a widely acknowledged

Keywords: Evaluation, Cardiopulmonary Resuscitation, Nurses Knowledge, AL-Diwaniyah

4. RESULTS AND DISCUSSION

Table 1: The demographic characteristics of the participants

Table 2: The overall level of knowledge of participants

18. Cardiac arrest occurs…? 30 60 20 40

Table 3: shows the overall level of knowledge of the participants.

Table 4: the relationship between demographic variables and overall knowledge

5. CONCLUSION AND RECOMMENDATIONS

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