運用即時回饋裝置提升護理人員心肺復甦品質成效

The Effect of Using a Real-Time Feedback Device on the Quality of Cardio Pulmonary Resuscitation (CPR) Performed by Nursing Staff

背景病人發生心跳停止時，立即進行心肺復甦術（cardiopulmonary resuscitation, CPR）已是標準急救措施，因此，CPR執行品質攸關心臟停止病人的存活率。
目的探討運用即時回饋裝置提升護理人員CPR執行品質及CPR自我效能之成效。
方法本研究採隨機對照研究設計，共納入72位護理人員（實驗組38位，對照組34位），使用即時回饋裝置記錄及提供CPR品質回饋，所有研究對象都執行五次CPR循環（約2分鐘），執行期間僅有實驗組使用即時回饋裝置，對照組則未使用，並使用問卷收集研究對象基本屬性及CPR自我效能分數。
結果本研究結果顯示：即時回饋裝置能顯著提升胸部按壓速率正確比率（76.3 vs. 52.3, p < .001）、平均深度（52.8 mm vs. 50.6 mm, p = .003）、深度正確比率（65.6 vs. 55.1, p = .014）、CPR執行品質分數（44.1vs. 26.1, p < .001）、達高品質CPR標準比率（60.5 vs. 26.5, p < .001）及CPR自我效能分數（40.22 vs.36.71, p < .001）。按壓後完全回彈比率及胸部按壓佔總急救時間（chest compression fracture）比率則未達到顯著差異（p > .05）。
結論使用即時回饋裝置可以使護理人員在急救安妮上有更良好的CPR執行品質，並提升對於能正確執行CPR的自信心。

Background: Cardiopulmonary resuscitation (CPR) is a standard procedure delivered to patients experiencing cardiac arrest. CPR quality is associated with the rate of survival of patients with cardiac arrest.
Purpose: To determine the efficacy of a real-time feedback device in terms of improving CPR performance quality and CPR self-efficacy in nursing staffs.
Methods: A total of 72 nursing staffs were enrolled in this randomized trial (intervention n = 38, control n = 34). A real-time feedback device was used to monitor CPR quality and provide real-time feedback. The participants performed CPR on a manikin with (intervention) or without (control) feedback for 5 cycles (about 2 minutes). Data on participant demographic characteristics and CPR self-efficacy scores were also collected.
Results: The intervention group performed better in terms of the compression adequate rate ratio (76.3 vs. 52.3, p < .001), mean depth (52.8 mm vs. 50.6 mm, p = .003), adequate depth ratio (65.6 vs. 55.1, p = .014), quality of CPR performance score (44.1 vs. 26.1, p < .001), proportion of excellent CPR (60.5 vs. 26.5, p < .001), and CPR self-efficacy score (40.22 vs. 36.71, p < .001). However, no significant differences between the two groups were found in terms of proportion of complete chest decompression and chest compression fracture (p > .05).
Conclusions: Using a real-time feedback device may not only significantly improve the quality of CPR performed on a manikin but also improve self-confidence to implement CPR correctly in practice.