Hospitals can add a CPR self-taught course to DP

Study showed successful launch

The hospital discharge process for cardiopulmonary patients could offer patients' families and friends a video self-instruction course on cardiopulmonary resuscitation (CPR) that improves discharge education and has the potential to save lives.

"We piloted a program, offering CPR training to family members and friends of patients in cardiovascular resuscitation," says Audrey Blewer, MPH, research coordination, at the University of Pennsylvania in Philadelphia. The CPR training program is affiliated with the university's Center for Resuscitation Science, department of emergency medicine.

Trained assistants offered the training to family members during the afternoons and early evenings, when more family members and friends were visiting cardiac patients. "If somebody accepted the training, we took them to a private conference room and administered the kit," Blewer says.

The American Heart Association developed the video self-instruction tool, which shows people how to administer CPR. It includes a 25-minute video and a mini-mannequin that blows up into a half-torso, a replicated head and chest area of a person. When someone practices on the mini-mannequin with chest compression, it will make a clicking noise to show it is being compressed appropriately. Also, people can blow into the mouth of the mannequin and cause the chest to rise.

Each patient would view the video with the trained assistant observing and answer questions. Then the assistant would help the trainee blow up the mannequin and begin the CPR practice. This process typically took 45 minutes.

"The mannequin is designed so individuals can practice chest compression," Blewer says. "They encourage people to push hard and fast in the center of the chest." When the chest is compressed adequately, there is a clicking sound.

The kit was designed for use by even elderly adults.

"We've trained individuals over 80, and almost anybody could do it without any problems," she says. "It's like a beach ball with the same mouth and stick cap on the mannequin."

Once trainees completed the CPR program, they were encouraged to take home the video and mannequin and share the self-taught course with their family members and friends.

Blewer and co-investigators conducted the CPR self-instruction video training program as a pilot study to improve discharge education about CPR. While hospitals could give patients and caregivers the CPR kit to view and use at home, there likely would be inadequate follow-through, she notes.

"The research assistant is there to make sure they don't run into technical difficulties," Blewer says. "One of the main points we wanted to show or conclude was that the hospital serves as a unique point of capture to train family members and friends in CPR."

The study followed participants after their self-instruction session and had them demonstrate CPR on a full-size mannequin, called the skill reporter mannequin, which is used in group CPR courses.

"This mannequin has a computer that tracks an individual's heart compression rate and ventilation quality," Blewer says.

The results confirmed that people had learned how to conduct CPR adequately, she adds.

The hospital has continued the self-instruction CPR training since the study ended. There is no retesting with the skill reporter mannequin, however, she says.

For hospitals to implement this program, it requires a steady supply — maybe 50 of the CPR kits and trained staff to serve the role of the assistance. The people working with patients undergoing CPR training could be nurses or some other discipline. Or they could even be well-trained volunteers, Blewer suggests.


• Audrey Blewer, MPH, Research Coordination, University of Pennsylvania, Center for Resuscitation Science, Department of Emergency Medicine, Philadelphia, PA. Telephone: (267) 239-1765.