Institutional factors associated with effective cardiopulmonary resuscitation among health workers at a County Referral Hospital in Kenya

Abstract

BACKGROUND
Cardiopulmonary resuscitation (CPR) is a very critical practise in the healthcare setting. WHO recommends CPR be initiated within the first three(3) minutes of an arrest. By 2015, mortalities related to cardiac arrest were estimated to be 300, 000 to 370 000 annually[1].

AIM
This study aimed to assess the above factors at a County Referral Hospital in Kenya.

METHODOLOGY
A descriptive cross-sectional design was adopted with a permission from the Institution to collect data. A total of 175 health care providers aged between 18-39 years and had served at the Nakuru County Referral Hospital for more than 6 months participated in the study. Students and staff on internship were excluded. Self- administered questionnaires were used. To gurantee their validity and checklists were practical, a pre-test was done at Thika Level 5 hospital since it shared the same characteristics. Ambiguous questions were rephrased. Data analysis was done using SPSS computer software, version 24 while demographic data were analysed by descriptive statistics.

RESULTS
The study reported inadequate staffing. The response was 92.5% with a majority 69.1 %( n=112) being females. Basically (89.5%) of them were nurses, a profession where females are the majority. Respondents 18-29 years were 36.4% (n=59) while those aged between 30 and 39 years accounted for 32.1%(n=52). The mean age was 32 years. The vast majority of respondents were young (<40 years). Some respondents (51.9% (N=81), indicated that, they did not have all the necessary resources for CPR. Having a BLS/ACLS certificate (p=0.042), a refresher course in the last 2 years (p=0.029) and necessary resources (p=0.034) was significant. All respondents had the minimum required level of education for their profession, ie, 52.8% (n=85) had acquired a diploma in nursing while 31.7% (n=51) had a bachelor's degree. All cadres of health workers participated spreading out across the various departments at the study site. The medical ward had 25.9% (n=42) while 24.7% (n=40) worked in the surgical ward.

CONCLUSION
The study Confirmed that, institutional factors influence effective Cardiopulmonary Resuscitation. Effective CPR improves the patients' outcomes reducing mortality related to cardiac arrest (CA). Early detection of cardiopulmonary arrest and initiation of CPR greatly influence the outcomes of CPR. Lack of debriefing following CPR among Health workers contribute to ineffective and repeated mistakes when conducting CPR. Understaffing in the hospital setting limits the number of personnel who assist in the practice. The fatigue experienced by the rescuer prevents optimal chest compression. The sub-Saharan region lack documented information to enlighten the public about the problem.

RECOMMENDATION
Hospital administrators should guarantee the provision of both human and material resources. Policy makers aught come up with policies to ensure that, all staff members are trained on CPR protocols.