Evaluation of Staff's Retention of BCLS and ACLS Skills

Purpose: The purpose of this research project was (1) to evaluate the ability of nursing staff to perform basic and advanced cardiac life support (BCLS and ACLS, respectively) resuscitation for the management of cardiopulmonary arrest or cardiac/respiratory emergencies; and (2) to determine the length of time these participants retain the ability to perform the required skills to standard.

Design: A prospective, randomized, longitudinal, repeated-measures, quasi-experimental design was employed. All participants were tested three times (initial [before training] test, posttraining test, and final test). Participants were randomized into four groups defined by the period of time that elapsed between the posttraining test and the final test (3, 6, 9, or 12 months).

Sample: The sample for this study was a convenience sample drawn from active duty, civil service, and reserve registered nurses working at Brooke Army Medical Center. A total of 133 participants were enrolled, with 51 ACLS and 52 BCLS participants completing the testing.

Instrumentation: The American Heart Association's BCLS and ACLS skill checklists were used for all written and performance testing.

Methods: Simulated emergency resuscitation scenarios were presented to registered nurses who had completed ACLS or BCLS courses in the previous 10┬╜ months. Each participant completed a written test and a performance test at three intervals to include initial testing, posttraining testing, and final testing.

Analysis: The following statistics were used to answer the research questions: frequencies, measures of central tendency, measures of dispersion, chi-square statistics, Pearson's correlation, ANOVA, and logistic regression.

Findings: The findings in this study indicate a short time period for retention of resuscitative performance skills. The majority (71%) of subjects could not successfully complete BCLS on initial test. Skill retention started to deteriorate at 3 months (63% passing rate) and progressively worsened to a maximum of 58% passing at 12 months. Skill retention for ACLS was alarmingly low, with only a 30% passing rate at 3 months and diminishing to a mere 14.3% passing rate at 12 months.

Nursing Implications: Registered nurses in this study are not retaining BCLS or ACLS skills for the entire length of time between training courses. Skill degradation is occurring as early as 3 months after resuscitation training. This research has significance to nursing because the topic addresses the survival of patients and basic nursing interventions that affect the quality of patient outcome in life-threatening situations.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2007107659.xhtml