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Effect of Cardiopulmonary Resuscitation Education on CPR Knowledge among Healthcare Workers in Nigeria

Abstract

Cardiac arrest is a life-threatening emergency that requires immediate recognition and prompt cardiopulmonary resuscitation (CPR) to improve the likelihood of survival and reduce the risk of severe neurological injury. Healthcare workers are expected to possess adequate knowledge of CPR because they may encounter cardiac arrest in hospitals, emergency departments, outpatient settings, community health facilities, and other healthcare environments. Cardiopulmonary resuscitation education provides healthcare workers with knowledge and practical information relating to recognition of cardiac arrest, activation of emergency response systems, chest compressions, ventilation, use of automated external defibrillators where available, basic life support sequence, airway management, emergency communication, and post-resuscitation procedures. CPR knowledge refers to healthcare workers' understanding of the principles, sequence, indications, techniques, and appropriate response procedures involved in cardiopulmonary resuscitation. In Nigeria, inadequate access to regular CPR training, limited opportunities for refresher education, high workloads, staff shortages, inadequate resuscitation equipment, and variations in emergency response systems may affect healthcare workers' CPR knowledge and preparedness. Effective CPR education may improve knowledge retention, emergency recognition, confidence, and understanding of appropriate resuscitation procedures. Against this background, this study investigates the effect of cardiopulmonary resuscitation education on CPR knowledge among healthcare workers in Nigeria. The study is anchored on Social Cognitive Theory, the Knowledge-Attitude-Practice framework, and Experiential Learning Theory. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping healthcare workers' emergency response behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how structured CPR education may improve knowledge and preparedness to respond to cardiac arrest. Experiential Learning Theory emphasizes learning through practical experience, demonstration, simulation, reflection, and application, making it particularly relevant to CPR education. Collectively, these theoretical perspectives provide a suitable framework for explaining how CPR education may influence CPR knowledge among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from healthcare workers in selected public and private healthcare facilities in Nigeria using a structured self-administered questionnaire and a standardized CPR knowledge assessment. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, clinical departments, and eligible healthcare workers. Where feasible, selected healthcare facilities or healthcare worker groups will be assigned to intervention and comparison groups. Healthcare workers in the intervention group will receive structured CPR education covering recognition of cardiac arrest, activation of emergency response systems, basic life support sequence, high-quality chest compressions, ventilation, airway management, use of automated external defibrillators where available, emergency communication, and post-resuscitation procedures. CPR knowledge will be assessed using indicators such as recognition of cardiac arrest, knowledge of the appropriate CPR sequence, recommended chest-compression principles, ventilation procedures, use of automated external defibrillators, emergency response activation, and appropriate actions during different cardiac arrest scenarios. Where feasible, clinical case scenarios will be incorporated to assess the application of knowledge to realistic cardiac arrest situations. Descriptive statistics will be used to summarize healthcare workers' sociodemographic and professional characteristics, previous CPR training, exposure to CPR education, and CPR knowledge scores. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of CPR education on CPR knowledge. Where appropriate, pre-intervention and post-intervention knowledge scores will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that CPR education has a significant positive effect on CPR knowledge among healthcare workers in Nigeria. Healthcare workers exposed to structured CPR education are expected to demonstrate improved knowledge of cardiac arrest recognition, CPR sequence, chest compressions, ventilation, airway management, emergency response activation, and defibrillation procedures. Education may improve healthcare workers' understanding of the importance of initiating CPR promptly and following an organized emergency response sequence. Regular refresher education and simulation-based training may further strengthen knowledge retention and emergency preparedness. However, education alone may not guarantee effective CPR performance in clinical settings because healthcare workers may continue to face barriers such as inadequate resuscitation equipment, limited access to automated external defibrillators, insufficient emergency response systems, high workloads, staff shortages, and inadequate opportunities for practical skills reinforcement. Consequently, CPR education is expected to be most effective when supported by regular simulation-based training, functional resuscitation equipment, accessible emergency response protocols, adequate staffing, supportive supervision, and continuous professional development. The study is expected to contribute to the literature on cardiopulmonary resuscitation, emergency care, healthcare worker education, cardiac arrest preparedness, basic life support, patient safety, clinical training, and public health in Nigeria by providing empirical evidence on the effect of CPR education on CPR knowledge among healthcare workers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, healthcare professional regulatory bodies, medical and nursing training institutions, emergency care programmes, hospital management authorities, professional associations, development partners, and policymakers regarding strategies for improving healthcare workers' preparedness to respond to cardiac arrest. The study will also provide evidence-based recommendations for integrating CPR education into healthcare worker training and continuing professional development, strengthening simulation-based resuscitation training, ensuring availability of essential resuscitation equipment, conducting regular competency assessments and refresher courses, and improving emergency response systems within Nigerian healthcare facilities.

Keywords: Cardiopulmonary resuscitation education, CPR knowledge, healthcare workers, cardiac arrest, basic life support, emergency care, resuscitation training, healthcare worker education, patient safety, emergency preparedness, clinical training, public health, Nigeria.