Abstract
Objective:
The aim of this study was to investigate the knowledge and attitude regarding advanced cardiac life support among healthcare workers, 2022.
Methods:
A cross-sectional study was conducted from March to May 2022 among healthcare workers who were working in Felege Hiwot Comprehensive Specialized Hospital Bahir Dar, Ethiopia. All physicians and nurses who were willing to participate this study were involved. A structured self-administered questionnaire was used for data collection. The data were entered into the statistical software Epi Data version 4.6.0.4 and analyzed with statistical package for social science version 26. Logistic regression analysis was used to differentiate the effects of each independent variable on the dependent variable.
Results:
Among the total study participants (400) with a response rate of 96%, most (238) (59.5%) healthcare workers (nurses and physicians) had poor knowledge toward advanced cardiac life support. Two hundred twenty-five (56.25%) healthcare workers had positive attitude. Being a physician, having more than 6 years of work experience, working in an emergency department for more than 10 years, and having advanced cardiac life support training all contribute to superior knowledge of advanced cardiac life support.
Conclusion:
Most healthcare workers, especially, nurses, have under estimated knowledge and a negative attitude toward advanced cardiac life support. This implies they require knowledge building and attitude empowerment regarding advanced cardiac life support. Being a physician, having training in advanced cardiac life support, having work experience of more than 6 years, and working in an emergency unit for more than 10 years were positively associated with better knowledge of advanced cardiac life support among healthcare workers.
Keywords: Advanced cardiac life support, attitude, knowledge
Introduction
Advanced cardiac life support includes recognition of signs of sudden cardiac arrest (SCA), heart attack, and complete airway obstruction, as well as performing cardiopulmonary resuscitation (CPR) and defibrillation with an automated external defibrillator (AED).1 It is a set of life-saving protocols and skills that extend basic cardiac life support to further support the body perfusion and provide an open airway and adequate ventilation.2 It includes tracheal intubation, rapid sequence induction, cardiac defibrillation, transcutaneous pacing, intravenous cannulation, and medication administration.3 Healthcare workers are educated and trained in advanced cardiac life support to provide effective and efficient health care during their professional lives.4 Because the dynamic and uncertain nature of the healthcare environment requires competent professional healthcare workers to manage the rapidly changing clinical environment.4–6 Based on healthcare providers’ level of education and experience, healthcare workers, especially nurses may have poor knowledge of advanced cardiac life support because it is often not a required part of their training and credentialing.7 Healthcare workers are usually the first responders in cases of hospital cardiac arrest. Their knowledge of advanced cardiac life support is important for improving patient outcomes. They need to be knowledgeable and have a positive attitude toward advanced cardiac life support. Since, advanced cardiac life support is a key component of the chain survival that increases the rate of survival to hospital discharge.4,8
Most health professionals suggest that resuscitation knowledge is not well developed due to a lack of formal training with in medical and nursing careers.7 The resuscitation guidelines recommend that all medical personnel working in the intensive care unit and emergency room, as well as those who provide patient resuscitation, receive regular advanced cardiac life support training.2,9 Previous studies revealed that there is a lack of consistency in training health professionals on advanced cardiac life support.4,10
Medical staff should have good knowledge of advanced cardiac life support before undergoing advanced drug administration, rapid sequence intubation, and cardiac resuscitation.11 Every medical professional (doctor, anesthesia, paramedics, and nurses) who is prone to emergencies must be on standby at all times to save lives and improve the quality of cardiac resuscitation.7,11 Healthcare professionals frequently face life-threatening situations, and must predetermine the need for resuscitation by considering risk factors like hypoxia, hypothermia, hypoglycemia, acidosis, and trauma.12
Many countries have guidelines on how to provide advanced cardiac life support, which are expressed by professional medical bodies in those countries.1 Creating awareness and educating the medical staff is essential to preventing delays in starting cardiac resuscitation.13 Medical staff are frequently the first responders to hospital cardiac arrests, and the success of a resuscitation may be a reflection of their knowledge and attitude of a recent advanced cardiac life support guidelines.2,9
In Ethiopia, advanced cardiac life support is not as widely developed as in other developed countries due to the lack of modern medical instruments and well-trained professionals.14,15 However, in Addis Ababa, the capital of Ethiopia, there are governmental institutions that provide medical equipment and training to healthcare professionals (physicians and nurses).16 In additional, they are international and private institutions that provide the much needed training and equipment.16
Generally, the knowledge and attitude of most medical personnel regarding advanced cardiac life support are lower than expected.16 The study conducted in Gondar (Northwest Ethiopia) toward CPR showed that only 25.15% and 60.8% of healthcare workers (physician and nurses) had good knowledge and a positive attitude, respectively.16 In this study setting (Felege Hiwot Comprehensive Specialized Hospital (FCSH), Bahir Dar, Ethiopia) there is no regular CPR and advanced cardiac life support training due to the limited resources in the country. According to the investigators’ observations over the last 2 years, most healthcare workers (nurses and physicians) who work at FCSH have poor awareness of advanced cardiac life support. Currently, there are no studies have been conducted regarding knowledge and attitudes toward advanced cardiac life support among healthcare workers at Felege Hiwot Referral Hospital. Therefore, this study aimed to investigate knowledge and attitudes toward advanced cardiac life support among healthcare workers working at FCSH.
Methods
Study design, area, and period
An institutional-based cross-sectional study design was conducted from March to May 2022. The study was conducted at FCSH. It is located in Bahir Dar City, which is the capital city of Amhara National Regional State. It is one of the biggest Comprehensive Specialized Hospital in the Amhara region and in the country at large. It serves 2000 people per day and has more than 273 beds. Currently, the hospital has a total of 322 nurses and 94 physicians. Bahir Dar City is located on the southern beach of Lake Tana, the source of the Blue Nile (Abay). Bahir Dar City is one of the 10 most beautiful cities in Africa.17
Inclusion criteria
Healthcare workers who had frequently involved in advanced cardiac life support (nurses and physicians) were involved.
Exclusion criteria
Other healthcare workers who had not frequently involved in advanced cardiac life support (pharmacists, laboratory professionals, and midwives) were excluded.
Sample size, sampling procedure, and technique
The actual sample size for the study was calculated using the single population proportion formula {n = [(zα/2)2 p(1 − p)]/d2}, n = sample size, zα/2 = 95% confidence level, p = the proportion of knowledge of healthcare workers toward advanced cardiac life support in the previous study (43.5%) was used.18 d = margin of error (0.05). Considering the 10% non-response rate, the final sample size of the study was 416 (322 nurses and 94 physicians). The authors considered the proportion of healthcare workers with a positive attitude and the factor that determines the knowledge of healthcare workers using Epi-Info. However, the sample size that was calculated was less than the calculated proportion (knowledge), so the authors took the largest one. The data were collected consecutively for each physician and nurse, since all nurses and physicians who were willing to participate in this study were involved.
Data collection tools and materials
The English version of the self-administered questionnaire was used to collect the data. The tools were divided into three sections: participant sociodemographic, knowledge, and attitude questions, which measure the main finding of this study. Data were collected from the study population via structured, self-administered questionnaires, which were adapted from various pieces of literature.1,16 The questioners were distributed sequentially to each study participant. Before collecting data for 4 weeks, two professional experts (one from the English language and one from the medical field) validated the tool and confirmed its reliability (Cronbach alpha of 0.86).2
Data quality control
The data collectors were three nurses. The two nurses has degree in Bachelor of Science (BSc) and the other one has Master of Science (MSc) in nursing. Data collectors were trained 2 days before the actual data collection. During the data collection period, the principal investigator closely monitored and provided necessary corrections and directions.
Statistical analysis
Before analyzing the data, it was cleaned up and cross-checked. The data were entered into Epi Data version 4.6.0.4 and exported to Statistical Package for Social Science (SPSS) version 26 for further analysis. A binary logistic regression model was used to estimate the associated factors of all independent variables with a p-value of <0.05. The model fitness of the variable was tested using Hosmer’s and Lemeshow’s test. All independent variables with a p-value of <0.05 from a bivariate logistic regression analysis were considered for fitting into a multivariable logistic regression analysis to control the possible effect of confounders. Descriptive statistics like percentage, mean, median, and standard deviation were used. Tables and narrations were used for data presentation.
Operational definitions
The variables were operationalized based on the previous study on the knowledge and attitude of healthcare workers toward basic life support (BLS).16,19,20
Good knowledge: Healthcare workers who answered 50% or more of the knowledge questions correctly.
Poor knowledge: Healthcare workers who answered below 50% of knowledge questions.
Positive attitude: Healthcare workers who answered 50% or higher on attitude questions.
Negative attitude: Healthcare workers who answered below 50% on attitude questions.
Results
Sociodemographic characteristics of study participants
Of the total study population (416), 400 (96%) healthcare workers participated in this study. There were no missing items during the analysis. Slightly more than half (225, or 56.25%) of the study participants were female. The majority of healthcare workers (51.25%) were between the ages of 31 and 40, with mean age of 36 ± 8.45. Two hundred eight (52%) participants were single. Most of the study participants, 317 (79.25%), were orthodox in religion. Three hundred twelve (78%) of healthcare workers were nurses (Table 1).
Table 1.
Sociodemographic characteristic of study participants.
| Variables | Category N = 400 | Frequency (%) |
|---|---|---|
| Sex | Female | 225 (56.25) |
| Male | 175 (43.75) | |
| Age | 18−30 | 133 (33.25) |
| 31−40 | 205 (51.25) | |
| 41−50 | 35 (8.75) | |
| ⩾51 | 27 (6.75) | |
| Marital status | Single | 208 (52) |
| Married | 150 (37.5) | |
| Others | 42 (10.5) | |
| Religion | Orthodox | 317 (79.25) |
| Muslim | 64 (15.25) | |
| Protestant | 19 (4.75) | |
| Work experience | 0−1 year | 39 (9.75) |
| 2−5 years | 102 (25.5) | |
| 6−10 years | 154 (38.5) | |
| Over 10 years | 105 (26.25) | |
| Working duration in emergency | 0−1 year | 56 (14) |
| 4−5 years | 157 (39.25) | |
| 6−10 years | 131(32.75) | |
| Over 10 years | 56 (14) | |
| Training on advanced cardiac life support | No | 189 (47.25) |
| Yes | 211 (52.75) | |
| Profession | Nurses | 312 (78) |
| Physician | 88 (22) | |
| Monthly income (Ethiopian birr) | 2500−4100 | 30 (7.5) |
| 4200−5200 | 25 (6.25) | |
| 5300−6599 | 200 (50) | |
| 6600−7499 | 70 (17.5) | |
| ⩾7500 | 75 (18.75) |
Knowledge of healthcare workers toward advanced cardiac life support
Among the study participants (400), most of them (238, or 59.5%) had poor knowledge. The mean score of the participants was 6.12 ± 1.57 standard deviations (from 15 knowledge questions) (Table 2).
Table 2.
Knowledge level of healthcare workers toward advanced cardiac life support.
| No. | Questions | Knowledge level of healthcare workers (with correct answer) |
|---|---|---|
| 1 | Abbreviation of advanced cardiac life support | 158 (39.5%) |
| 2 | What is your initial intervention (assistance) for an unresponsive patient presented in your hospital? | 142 (30.75%) |
| 3 | What is your immediate intervention (treatment) if the victim has no pulse? | 142 (30.75%) |
| 4 | What is location of chest compression? | 118 (29.5%) |
| 5 | What is depth of chest compression for adults? | 139 (34.75%) |
| 6 | What is adult advanced cardiac life support maximum joule for shockable rhythm | 239 (59.75%) |
| 7 | What are non-shockable rhythms? | 156 (39%) |
| 8 | What is the CPR rate of compression for adults? | 197 (49.25%) |
| 9 | What are shockable rhythms? | 167 (41.75%) |
| 10 | What are the reversible causes of cardiac arrest? | 179 (44.75%) |
| 11 | What is the dose and frequency of adrenalin for advanced cardiac life support? | 56 (14%) |
| 12 | What is the indication of amiodarone for advanced cardiac life support? | 78(19.5%) |
| 13 | What is the dose of amiodarone for advanced cardiac life support? | 97(24.25%) |
| 14 | Is magnesium sulfate used for advanced cardiac life support? | 34 (8.5%) |
| 15 | What is post-cardiac arrest care? | 96 (24%) |
Attitude of healthcare workers toward advanced cardiac life support
From the total study participants (400), 225 (56.25%) had a positive or good attitude, while 175 (44.75%) had a negative or poor attitude toward advanced cardiac life support (Table 3).
Table 3.
Response of healthcare workers for advanced cardiac life support attitude questions.
| No. | Knowledge questions | Response | Frequency (%) |
|---|---|---|---|
| 1 | Do you understand the role of nurses or physicians in advanced cardiac life support? | Yes | 204 (51) |
| No | 196 (49) | ||
| 2 | Have you thought advanced cardiac life support perform as a physician or nurse? | Yes | 192 (48) |
| No | 208 (52) | ||
| 3 | Have you considered learning more about advanced cardiac life support? | Yes | 179 (44.75) |
| No | 231 (57.75) | ||
| 4 | Can you document patient care thoroughly? | Yes | 188 (47) |
| No | 212 (53) | ||
| 5 | Can you communicate effectively during advanced cardiac life support care? | Yes | 200 (50) |
| No | 200 (50) | ||
| 6 | Have you thought advanced cardiac life support has legal and ethical issues? | Yes | 165 (41.25) |
| No | 235 (58.75) | ||
| 7 | Can you recognize the signs and symptoms of cardiac arrest as a physician or nurse? | Yes | 204 (51) |
| No | 196 (49) | ||
| 8 | Can you please prioritize actions for advanced cardiac life support? | Yes | 216 (54) |
| No | 184 (46) | ||
| 9 | Can you take advanced cardiac life support action based on the patients’ condition? | Yes | 111 (27.75) |
| No | 289 (72.25) | ||
| 10 | Have you understood the principle of advanced cardiac life support? | Yes | 192 (48) |
| No | 208 (52) | ||
| 11 | Can we evaluate patient responses based on the advanced cardiac life support protocol? | Yes | 114 (28.5) |
| No | 286 (71.5) | ||
| 12 | I think I succeeded as a physician/nurse on advanced cardiac life support | Yes | 197 (49.25) |
| No | 203 (50.75) |
Factors associated with knowledge of healthcare workers toward advanced cardiac life support
The goodness of fit of the variable using Hosmer’s and Lemeshow’s test showed that 98% of the dependent variables were explained by the dependent variables. Based on the binary logistic regression analysis, profession, work experience, working in emergency, and having training in advanced cardiac life support were significantly associated with the knowledge of advanced cardiac life support. A physicians had twice higher knowledge compared with nurses. Those who had received advanced cardiac life support training had five times higher knowledge than those who had not. Healthcare workers who were worked in an emergency department for more than 10 years had 12 times higher knowledge than those who worked in an emergency department for less than a year. Healthcare workers who have more than 10 years of work experience had six times higher knowledge compared with those with less than a year of work experience (Table 4).
Table 4.
Factors associated with knowledge of healthcare workers toward advanced cardiac life support.
| S. no. | Variables | Category | Knowledge | COR (95%) CI | AOR (95%) CI | p-Value | |
|---|---|---|---|---|---|---|---|
| Good | Poor | ||||||
| 1 | Work experience | 0−1 year | 24 | 15 | 1.00 | 1.00 | |
| 2−5 years | 50 | 52 | 0.29 (0.64, 1.821) | 3.24 (0.66, 16.00) | 0.114 | ||
| 6−10 years | 94 | 60 | 7.24 (3.023, 11.25) | 5.72 (1.42, 10.27) | 0.013* | ||
| Over 10 years | 70 | 35 | 3.121 (1.054, 5.728) | 6.445 (1.35, 8.66) | 0.019* | ||
| 2 | Duration of working in current emergency | 0−1 year | 19 | 37 | 1.00 | 1.00 | |
| 4−5 years | 109 | 48 | 1.553 (0.576, 4.183) | 0.98 (0.07, 13.74) | 0.992 | ||
| 6−10 years | 75 | 56 | 0.474 (0.243, 0.925) | 9.24 (.65, 30.9) | 0.100 | ||
| Over 10 years | 35 | 21 | 3.214 (1.26, 6.030) | 12.18 (11.01, 15.50) | 0.049* | ||
| 3 | Training on ACLS | No | 127 | 62 | 1.00 | 1.00 | |
| Yes | 111 | 100 | 2.43 (1.264, 5.389) | 5.13 (2.23, 7.32) | 0.024* | ||
| 4 | Profession | Nurses | 112 | 200 | 1.00 | 1.00 | |
| Physician | 45 | 43 | 2.02 (1.514, 4.993) | 1.79 (1.445, 3.24) | 0.002* | ||
AOR, adjusted odds ratio; 1.00, reference; COR, crude odds ratio; ACLS, advanced cardiac life support; CI, confidence interval.
p-Value <0.05, which is significantly associated with healthcare workers toward advanced cardiac life support.
Discussion
In developing countries such as Ethiopia, SCA, along with poor basic and advanced cardiac life support practice, is one of the leading causes of death.16 In fact, following BLS, advanced cardiac life support is crucial to reducing mortality caused by cardiac arrest. In a developing country like Ethiopia, the importance of adequate knowledge and a positive attitude toward basic and advanced cardiac life support is underappreciated, along with poor knowledge and a negative attitude.20 In this study, most healthcare workers had low knowledge regarding advanced cardiac life support, as did the total number of study participants (400); 238 (59.5%) had poor knowledge, while 162 people (40.5%) had good knowledge of advanced cardiac life support. This showed that most healthcare workers knowledge about advanced cardiac life support is under-estimated. This implies the knowledge of healthcare workers, especially nurses, was less than expected and needs attention to improve its current state. Therefore, they require special training in advanced cardiac life support to improve their knowledge of advanced cardiac life support. Because the patient’s or causality’s survival depends on the quality of BLS, the early initiation of basic and advanced cardiac life support, proper post-cardiac arrest care, and identifying the underlying cause of cardiac arrest. Empowering healthcare workers with advanced cardiac life support knowledge could potentially improve patient survival after cardiac arrest. In this study, the knowledge level of healthcare workers was contradicted with the studies conducted in New Zealand, Saudi Arabia, and Turkey; the knowledge level of healthcare workers in each country was 65%, 76%, 87%, and 86%, respectively,1,9,21 which is higher than the knowledge level of healthcare workers in this study. The difference could be attributed to differences in educational curriculum, study setting, study period, and accessibility of technology and machines like an AED. For example, in Ethiopia, advanced cardiac life support protocol is not incorporated into the curriculum (credential). In addition, the availability and accessibility of technological medicine is limited. For instance, there is no AED in the majority of hospitals in Ethiopia. Most healthcare workers did not take refresher training on both BLS and advanced cardiac life support in this study setting. In Ethiopia, BLS and advanced cardiac life support were not initiated early due to a delay in presentation and unwitnessed cardiac arrest.7,16,20,22
In this study, 225 (56.25%) healthcare workers were recorded as positive or having a good attitude regarding advanced cardiac life support, while 175 (43.75%) of them were negative or had a poor attitude toward performing advanced cardiac life support. This is different from the studies which were conducted in Saudi, Canada, Turkey, and Brazil which showed that 97%, 84%, 86%, and 79% had positive attitudes regarding performing advanced cardiac life support, respectively9,21,23,24 This implies a more positive approach than the approach taken by healthcare workers in this study to perform advanced cardiac life support. This contradiction might be due to the knowledge difference, the overcrowding of emergencies in this study setting, and the unavailability of medication and equipment to provide advanced cardiac life support.16 In Ethiopia, medications like amiodarone are frequently unavailable, and equipment such as an AED is also unavailable in most hospitals, including in this study setting (FCSH). Altogether it contributes the discrepancy in the attitude of healthcare workers.
In this study, a physician had twice higher knowledge compared with nurses. Those who had received advanced cardiac life support training had five times higher knowledge than those who had not. Healthcare workers who worked in an emergency department for more than 10 years had 12 times higher knowledge than those who worked in an emergency department for less than a year. Healthcare workers who have more than 10 years of work experience had six times higher knowledge compared with those with less than a year of work experience. It is known that knowledge can be acquired through training and work experience, thus, individuals who had long clinical experience at emergency departments and had training on advanced cardiac life support had a high probability of getting patients with cardiac arrest, leading them to understand advanced cardiac life support. In the Ethiopian educational curriculum, physicians have acquired their credentials with 7 years of academic experience, while nurses have acquired their credentials with 4 years of academic experience, so that physicians have a better understanding of advanced cardiac life support. This finding was supported by studies conducted in the United States, Nigeria, and Turkey.19,21,25
Limitation of the study
The study shared the cross-sectional study design’s limitation, which could be response bias.
The study excluded the practices of healthcare workers due to time constraints.
The study did not showed the knowledge and attitude difference between the status of healthcare workers, physicians (general practitioner, specialist, and subspecialist), and nurses (BSC degree and MSc degree).
Conclusion
This study showed that most healthcare workers have underestimated knowledge and have a poor or negative attitude toward advanced cardiac life support. Comparing the previous study that was conducted in other settings, in this study setting, the knowledge and attitude of healthcare workers toward advanced cardiac life support were particularly poor. This indicates that they require knowledge building and attitude empowerment regarding advanced cardiac life support. Being a physician, having training in advanced cardiac life support, work experience more than 6 years, and working in an emergency more than 10 years are strong positively associated with better knowledge of advanced cardiac life support. Therefore, providing consistent advanced cardiac life support training, accessing, and updating advanced cardiac life support guidelines for every healthcare workers are crucial to improving the knowledge and attitude of healthcare workers toward advanced cardiac life support.
Supplemental Material
Supplemental material, sj-docx-1-smo-10.1177_20503121221150101 for Knowledge and attitude of healthcare workers toward advanced cardiac life support in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia, 2022 by Ousman Adal and Solomon Emishaw in SAGE Open Medicine
Acknowledgments
The author is grateful to the data collectors, emergency coordinator, and all study participants for their contributions to the study’s success.
Footnotes
Author contributions: OA developed the proposal, analyzed the data, interpreted the results, and drafted the manuscript. SE revised the proposal, checked the data, and revised the manuscript. The author is read and approved the final manuscript.
Availability of data and materials: All the data that support to conduct this study are available on the manuscript.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical approval and informed consent to participants: Ethical approval for this study was obtained from College of Health Sciences at Bahir Dar University approved this study (ID no. ChM 299 bdu.net). Certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Informed consent: Written informed consent was obtained from all subjects (physicians and nurses) before the study.
ORCID iD: Ousman Adal 
https://orcid.org/0000-0001-7925-3411
Supplemental material: Supplemental material for this article is available online.
References
- 1. Lockey A, Conaghan P, Bland A, et al. Educational theory and its application to advanced life support courses: a narrative review. Resus Plus 2021; 5: 100053. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Tsushima T, Patel TR, Sahadevan J. Advanced cardiac life support algorithms—reply. JAMA Intern Med 2021; 181(8): 1141–1142. [DOI] [PubMed] [Google Scholar]
- 3. Gabbard KL, Smith-Steinert RM. Advanced cardiac life support simulation for nurse anesthetists and student nurse anesthetists. Clin Simul Nurs 2021; 50: 65–73. [Google Scholar]
- 4. Yadav P. Attending training workshop of BLS/ACLS. J Nepal Med Assoc 2022; 60(254): 916–917 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Silverplats J, Strömsöe A, Äng B, et al. Attitudes towards cardiopulmonary resuscitation situations and associations with potential influencing factors: a survey among in-hospital healthcare professionals. PLoS One 2022; 17(7): e0271686. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Namukwaya H, Aliga C, Nakate G, et al. Unit knowledge and practice of emergency nursing interventions at a tertiary public cardiac health center in Uganda. Int J Crit Care 2022; 16(2): 56. [Google Scholar]
- 7. Kim H-J, Lee H-C. Differences in advanced cardiac life support knowledge, confidence, satisfaction, and performance ability of paramedic students according to simulation education methods. Korean J Emerg Med Serv 2021; 25(3): 111–125. [Google Scholar]
- 8. Ullal NA, Sathis B, Farooqui MEA. Periodic reinforcement of knowledge and attitude towards basic life support skills among the medical undergraduates: a necessity of undergraduate medical education. Biomedicine 2022; 42(2): 333–337. [Google Scholar]
- 9. Srinivasan AP, Albalawe MA, Issrani R, et al. Awareness, knowledge, and attitude of Saudi students towards basic life support: a cross-sectional study. Pesquisa Brasileira em Odontopediatria e Clínica Integrada 2021; 21: e0043. [Google Scholar]
- 10. Bingham AL, Sen S, Finn LA, et al. Retention of advanced cardiac life support knowledge and skills following high-fidelity mannequin simulation training. Am J Pharm Educ 2015; 79(1): Article 12. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Jang K, Kim SH, Oh JY, et al. Effectiveness of self-re-learning using video recordings of advanced life support on nursing students’ knowledge, self-efficacy, and skills performance. BMC Nurs 2021; 20(1): 1–10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12. Kwiecień-Jaguś K, Mędrzycka-Dąbrowska W, Galdikienė N, et al. A cross-international study to evaluate knowledge and attitudes related to basic life support among undergraduate nursing students: a questionnaire study. Int J Environ Res Public Health 2020; 17(11): 4116. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Isa R, Rahmad N, Mohd SNS, et al. Knowledge and practice of basic life support (BLS) among registered nurse at a private hospital in Seremban. Malays J Nurs 2022; 13(3): 58–64. [Google Scholar]
- 14. Tadesse M, Seid SA, Getachew H, et al. Knowledge, attitude, and practice towards basic life support among graduating class health science and medical students at Dilla University: a cross sectional study. Ann Med Surg 2022; 82: 104588. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Ssewante N, Wekha G, Iradukunda A, et al. Basic life support, a necessary inclusion in the medical curriculum: a cross-sectional survey of knowledge and attitude in Uganda. BMC Med Educ 2022; 22(1): 1–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Abebe TA, Zeleke LB, Assega MA, et al. Health-care providers’ knowledge, attitudes, and practices regarding adult cardiopulmonary resuscitation at Debre Markos Referral Hospital, Gojjam, Northwest Ethiopia. Adv Med Educ Pract 2021; 12: 647. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17. Muluneh MW, Gebremichael SG. Determinants of intraocular pressure (IOP) of glaucoma patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Adv Public Health 2021; 2021: 5308376. [Google Scholar]
- 18. Atlaw WD. Patterns of occupational exposure to patients’ body fluids among health care workers in Tikuranbesa University Hospital, Addis Ababa, Ethiopia. 2013. [Google Scholar]
- 19. Ali S, Zahid A, Jamal SZ, et al. Cardiologists’ knowledge and perception towards American Heart Association guidelines of cardiopulmonary resuscitation; a letter to editor. Arch Acad Emerg Med 2021; 9(1): e11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20. Mersha AT, Egzi AHKG, Tawuye HY, et al. Factors associated with knowledge and attitude towards adult cardiopulmonary resuscitation among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: an institutional-based cross-sectional study. BMJ Open 2020; 10(9): e037416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Derinoz-Guleryuz O, Uysal-Yazici M, Udurgucu M, et al. The skills of defibrillation practice and certified life-support training in the healthcare providers in Turkey. Int J Clin Pract 2021; 75(12): e14978. [DOI] [PubMed] [Google Scholar]
- 22. Al-Kalaldeh M, Al-Olime S. Promoting nurses’ self-efficacy in advanced cardiac life support through high-fidelity simulation. J Contin Educ Nurs 2022; 53(4): 185–192. [DOI] [PubMed] [Google Scholar]
- 23. Keys E, Luctkar-Flude M, Tyerman J, et al. Developing a virtual simulation game for nursing resuscitation education. Clin Simul Nurs 2020; 39: 51–54. [Google Scholar]
- 24. Webster CS, Hallett C, Torrie J, et al. Advanced cardiac life support training in interprofessional teams of undergraduate nursing and medical students using mannequin-based simulation. Med Sci Educ 2018; 28(1): 155–163. [Google Scholar]
- 25. Lockey A, Lin Y, Cheng A. Impact of adult advanced cardiac life support course participation on patient outcomes: a systematic review and meta-analysis. Resuscitation 2018; 129: 48–54. [DOI] [PubMed] [Google Scholar]
Associated Data
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Supplementary Materials
Supplemental material, sj-docx-1-smo-10.1177_20503121221150101 for Knowledge and attitude of healthcare workers toward advanced cardiac life support in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia, 2022 by Ousman Adal and Solomon Emishaw in SAGE Open Medicine