Barriers to the success of cardiopulmonary resuscitation teams in emergency departments: A perspective from nurses.

Background: Cardiopulmonary arrest is one of the most important emergency situations in hospitals. Although cardiopulmonary resuscitation has long been the first step in these conditions, the low success rate of this process is still a major concern in treatment systems. Therefore, identifying the barriers and causes of failure of the cardiopulmonary resuscitation team has become an important factor in improving the results. The present study was conducted to identify the barriers to the success of cardiopulmonary resuscitation teams in emergency departments.

Methods: A descriptive-analytical study was conducted in the emergency department of teaching hospitals in Qazvin, Iran 2023-2024. Using available sampling, 198 emergency department nurses were included in the study. Nurses were included in the study if they had at least 6 months of work experience in the emergency department, had at least a bachelor's degree, and experienced at least one cardiopulmonary resuscitation operation. The exclusion criteria were incomplete completion of the questionnaires and withdrawal from the study for any reason. The data was collected using the demographic characteristics checklist and the questionnaire on barriers to the success of the cardiopulmonary resuscitation team. Data analysis was performed using SPSS-24 software and descriptive and inferential statistics. The significance level of all tests was considered less than p < 0.05.

Results: The mean age of the participants was 30.96 ± 5.15. Out of 198 nurses participating in the study, 125 were female (63.1%) and the rest were male. According to the results, the main barriers to the success of the cardiopulmonary resuscitation team in the emergency department are related to the individual and professional characteristics of the resuscitation team members with a score of 2.50 ± 0.38 and the least reason is related to the program and educational facilities dimension with a score of 2.32 ± 0.50. In the patient characteristics dimension, the initial rhythm (2.70 ± 0.58) and in the individual and professional characteristics of the resuscitation team members, the lack of skilled and experienced people (2.62 ± 1.51) were the main barriers to the success of the cardiopulmonary resuscitation team. From the nurses' point of view, in the dimension of resuscitation team management, the absence of an effective leader in the team (2.41 ± 0.64), in the dimension of equipment and devices needed for resuscitation, the absence and unpreparedness of resuscitation equipment and devices in the department (2.53 ± 0.55), and in the dimension of program and educational facilities related to resuscitation, the lack of adequate and appropriate educational facilities and equipment (2.40 ± 0.64) were the main barriers to the success of the cardiopulmonary resuscitation team. The results of the t-test showed that there is no significant relationship between age, gender, and educational qualification with the average score of the whole questionnaire (P > 0.05).

Conclusions: The results of this study showed that the individual and professional characteristics of cardiopulmonary resuscitation team members are the weak points and the most important barriers to the success of this team in the emergency department. Therefore, it is possible to reduce the barriers to the success of cardiopulmonary resuscitation and increase the survival rate of cardiopulmonary resuscitation by using experienced, skilled, and highly knowledgeable staff. Reducing or eliminating these barriers requires a detailed policy of managers and planners in individual, equipment, and training dimensions.