Comparison of the Effect of Training by Direct Feedback, Visual Feedback and Their Combination on the Quality of Chest Compressions in Nurses

Abstract

Background: Appropriate training methods enhance the quality of chest compressions (CC), a critical component of cardiopulmonary resuscitation (CPR), thereby improving outcomes for cardiac arrest patients. Objectives: This study aimed to evaluate the effects of visual, direct, and combined feedback on improving the quality of CC. Methods: In this field trial study, 90 nurses in Birjand were randomly assigned to three groups: Direct feedback, visual feedback, and combined feedback. The quality of CC on a manikin was assessed using a CPR METER (Q-CPR) before the intervention, immediately after the intervention, and two months later. Data were analyzed using SPSS 22 software, employing one-way ANOVA, one-way repeated measures ANOVA, paired samples t-test, and chi-square tests at a significance level of 0.05. Results: The baseline characteristics (resuscitation experience, work experience, participation in CPR workshops, age, and education level) showed no significant differences among the three groups. Before the intervention, the CC quality scores were similar across the groups (P < 0.05). Immediately after the intervention, the average CC quality scores in the direct, visual, and combined feedback groups increased significantly to 74.45 ± 8.17, 85.14 ± 5.15, and 95.67 ± 6.32, respectively (P < 0.05). In the two-month follow-up, compared to the immediate post-intervention scores, the average CC quality scores decreased to 66.29 ± 8.40, 78.13 ± 6.88, and 91.26 ± 7.29 in the direct, visual, and combined feedback groups, respectively. However, the rate of reduction in the combined feedback group was significantly lower than in the other groups (P < 0.0001). Conclusions: The quality of CC among nurses can be significantly improved through the use of direct, visual, and combined feedback. The combined feedback approach demonstrated superior effectiveness in both immediate improvement and sustained quality over time, highlighting its value in resuscitation training programs.