What is the Effect of Frequent Basic Life Support Refresher Sessions on Health Care Professionals’ Retention of Cardiopulmonary Resuscitation Skills? A Systematic Review

Abbreviations: AED, Automated External Defibrillator; AHA, American Heart Association; BLS, Basic Life Support; CPR, Cardiopulmonary Resuscitation; EBL, Evidence Based Librarianship; IDG, Instructor Directed Group; NHMRC, National Health and Medical Research Council; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta- Analyses; RCT, Randomised Control Trial; RFST, Repetitive Sessions of Formative Self Testing; RFSTAP, Repetitive Sessions of Formative Self Testing with Additional Practice ROSC, Return of Spontaneous Circulation; SDG, Student Directed Group. Abstract Background: Cardiopulmonary resuscitation training is currently provided to health care professionals at biannual intervals to meet mandatory recertification in accordance with guidelines.  However, literature reports that resuscitation skills decline rapidly and sometimes long before recertification. Inadequate CPR may result in a decrease in the incidence of achieving return of spontaneous circulation and other devastating outcomes. Good quality training and education in cardiopulmonary resuscitation is paramount to patient survival. Brief refresher sessions may prevent skill decay among health care professionals, improving skill retention over time and improving patient outcomes. Objective: The aim of this systematic review is to determine the effect of frequent basic life support refresher sessions on health care professionals’ retention of cardiopulmonary resuscitation skills. Methods: A systematic review using narrative analysis was completed.  A database search was conducted to identify relevant studies for inclusion.  Databases searched include Medline, Embase, CINAHL and The Cochrane Library. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the review. Results: Ten of the 11 studies in this paper concluded that basic life support refresher sessions may increase retention of cardiopulmonary resuscitation skills.  Two of the included studies discussed self-perceived confidence as a secondary outcome.  One of these two studies demonstrated a significant correlation between higher self-confidence and improved retention of cardiopulmonary resuscitation skills. Conclusion: Basic life support refresher sessions can have a positive impact on cardiopulmonary resuscitation skill retention among health care professionals.  However, the most effective method of delivering refresher sessions must be further clarified.  The optimal duration of these sessions as well as the optimal timing of delivering these sessions also requires further clarification through further research.