A Study to Assess The Knowledge And Practice Regarding Cardiopulmonary Resuscitation Among Nursing Students Of Agra, Uttarpradesh

Background: Cardiopulmonary resuscitation (CPR) is a life-saving operation performed in an emergency when the heart stops beating. Immediate CPR following a cardiac arrest can double or triple the odds of survival. The American Heart Association welcomes you to join us in our vision of a future without cardiac arrest. In the United States, 350,000 individuals die from cardiac arrest each year. CPR keeps the blood pumping and the body supplied with oxygen until specialized treatment is available. There is normally enough oxygen left in the blood to support the brain and other organs for a few minutes. Objective: To assess the knowledge and practice regarding cardiopulmonary resuscitation among diploma nursing students. Methods: Descriptive research design was used. This study included 60 students. Knowledge and practice checklist was used to assess the knowledge and practice and chi-square test used to see the association between dependent and independent variables. Result : In this study, level of knowledge regarding cardiopulmonary resuscitation pretest level poor knowledge 23(38.3%), poor knowledge 19(31.7%) and good knowledge 18(30%) . level of skills regarding cardiopulmonary resuscitation pretest level skills 60(100%) poor skills 0(0.0%) good skills. Age, Gender, religion, Course of study, Family history of cardiac disease, Aware about cardio pulmonary resuscitation, source of information regarding cardio pulmonary resuscitation, Classes on cardio pulmonary resuscitation within the last 6 months had shown no statistically significant association with the pretest levels of skills regarding cardio pulmonary resuscitation among students. Conclusion : Despite the fact that more than half of students had good knowledge, so students required proper skill development about cardio pulmonary resuscitation.


Introduction:
One of the most important organs in the human body is the heart.An adult's heart beats 72 times each minute on average.It is operational 24 hours a day, seven days a week.Our heart performs a simple yet vital function.It delivers oxygen-rich blood to every area of our bodies.When our heart stops pounding, oxygen does not reach our other critical organs, and they cease to function. 1 The heart is a muscular hollow organ.It measures 10 cm and is roughly the size of one's own fist.It weighs approximately 225 grammes in women and approximately 310 grammes in men.
Cardiac arrest is a common medical emergency that can be fatal.Cardiac arrest happens when the heart stops producing an efficient pulse and stops circulating blood throughout the body.It is characterized by a loss of consciousness as well as the absence of a pulse and blood pressure.Most of the time, the significant mortality linked with it can be readily avoided by some relatively easy manoeuvre and talents. 2 Coronary artery disease is the leading cause of sudden cardiac arrest.Approximately 60-70% of sudden cardiac deaths are related to coronary artery disease.The other causes of cardiac arrest include smoking, lack of physical exercise, obesity, diabetes, previous heart attack and family history of cardiac diseases.CPR traditionally has integrated chest compressions and rescue breathing with the goal of optimizing circulations and oxygenation.Rescuer and victim characteristics may influence the optimal application of the components of CPR.Everyone can be a life saying rescuer for a cardiac arrest victim.CPR skills and their applications depends on the rescuer's training, experience and confidence. 3est compressions are the foundations of CPR.All rescuer's regardless of training should provide chest compressions to all cardiac arrest victims.Because of their importance, chest compressions should be the initial CPR actions for all victims regardless of age.Rescuers who are able should add ventilations to chest Compressions.Highly trained rescuers working together should coordinate their care and perform chest compressions as well as ventilations in a team-based approach.Integrating the critical components of CPR. 4 It has been estimated that more than 7,000,000 people die of sudden cardiac death per year worldwide.In India, the annual incidence of sudden cardiac death accounts for per 1000 population.Almost 2.6 million Indians are predicted to die due to coronary artery disease, in India by 2020.The incidence of sudden cardiac deaths is increased in the age group of 45-75 years.It is also seen that men have a higher incidence of cardiac arrest than females. 5udies have shown that, in case of out-of-home cardiac arrest, bystanders, lay persons or family members attempt CPR in 14% to 45% of the time, and only half of bystanders perform CPR effectively.It was also found that when a cardiac arrest occurs in out of hospital setting, CPR was more commonly given by a bystander who has no connection to the victim than a member of his own family. 6This is because a stranger can remain calm and think clearly when compared to a family member.Only a minority of bystanders will initiate CPR when a family member collapses in the home.The main reason for not performing CPR was fear of failing.The study highlighted that CPR courses are not reaching to those most likely to be called upon to use this skill. 7owledge of BLS and practice of simple CPR techniques ensures the survival of the patient till experienced medical help arrives and in most cases that itself is sufficient for survival.Basic CPR can be performed by a trained health care professional and by appropriately trained non-professionals. 8

Study area and period
The study was conducted in selected nursing colleges at Agra

Study design
The research design was used in this study descriptive research design.

Population Source population: The source population was all nursing students
Study population: All sampled nursing students during study period.

Inclusion criteria and Exclusion criteria: Inclusion criteria ➢ Available at the time of data collection
➢ Interested for study ➢ The students who can read and write Hindi or English Sample size: 60 nursing students Sampling procedure

Independent variables
The independent variable in this study is relaxation technique.

Dependent variables
The dependent variable in this study is knowledge and practice of cardio pulmonary resuscitation Operational definition 1. Knowledge: In this study knowledge refers to the understanding of students regarding cardio pulmonary resuscitation, as measured by a structured questionnaire 2. Practice: In this study, it refers to the ability of students to perform cardio pulmonary resuscitation as measured by a checklist.

Cardio Pulmonary Resuscitation:
In this study, it refers to an emergency procedure used to temporarily maintain blood oxygenation and tissue perfusion, as well as restore cardiac function, in a person who has suffered cardiopulmonary arrest.

Nursing Students:
In this study, it refers to candidates studying degree and diploma course in selected nursing college. 5. Demonstration Method: in this study demonstration method in teaching can be defined as giving a demo or performing a specific activity or concept.

Data collection instrument and procedure
Structured and semi-structured English version questionnaire was prepared from the literature review by principal -investigators.Translation to Hindi version and again translated to English version were used by the principal investigators before starting the data collection time.It includes about sociodemographic, knowledge and practice questionnaire.

Data collection instrument and methods:
-The data collector was the group members.Face to face interview held privately after verbal consent is obtained from each participant.The data was collected until the required sample size achieved.

Data processing and analysis
The coded data were entered to computer by using Statistical Package for Social Science (SPSS) version 25 statistical software for analysis.Cleaning was performed by using frequency distribution.Any error were corrected after revision of the original data using the code numbers of the questionnaires.Frequencies were computed for description of the study population in relation to socio-demographic and other relevant variables.The association between independent and dependent variable determined by odd ratio with 95% CI and P-value less than considered as statistically significance.Chi-square test will be used to find association of the post-test anxiety score with selected demographic variables.In this study P-value < 0.05 was considered to declare a result as statistically significant association.The result presented by charts, figures, and tables.

Results and Discussion
Descriptive and inferential statistics were used for analyzing the data on the basis of objectives of the study.The data has been tabulated and organized as follows.Regarding Family history of cardiac disease of students maximum 42(70%) were no history of cardiac disease, 18(30%) yes about history of cardiac disease.According to aware about cardio pulmonary resuscitation student's majority 42(70%) were aware about cardio pulmonary resuscitation, 18(30%) were no aware about cardio pulmonary resuscitation.
Regarding Classes on cardio pulmonary resuscitation within the last 6 months, 20(33.3%)were attended classes and 40(66.7%)were not attended classes.

Table : 1
Frequency and percentage distribution of study samples according to the selected With regard to class of studying of students 36(61%) were bachelor of Nursing,14(23.7%) belongs to post Basic Nursing,10(15.4%) was Diploma Nursing.

Table 2 :
Assessment of levels of knowledge among students regarding cardio pulmonary resuscitation.

Table 3 :
Assessment of levels of Skills among students regarding cardio pulmonary resuscitation.The table 4shows that assessment of pretest level of skills regarding cardiopulmonary resuscitation pretest level skills 60(100%) poor skills 0(0.0%) good skills.

Table 7 :
Association between levels of knowledge and demographic profile or characteristics

Table 8 :
Association between levels of Practice and demographic profile or characteristics p<0.005*indicates significant S-Significant NS-non significantThe table8showed that demographic variables Age, Gender, religion, Course of study, Family history of cardiac disease, Aware about cardio pulmonary resuscitation, source of information regarding cardio pulmonary resuscitation, Classes on cardio pulmonary resuscitation within the last 6 months had shown no statistically significant association with the pretest levels of skills regarding cardio pulmonary resuscitation among students.P<0.005. *