The competency of nurses in basic life support at district hospitals in Cape Town, South Africa

Abstract

Background: Cardiac arrest (CA) is a leading cause of mortality, and survival rates are low; however, basic life support (BLS) can improve these rates. Nurses play a crucial role in the prevention, recognition, and response to CA, making BLS competency essential. Little is known about BLS competency among nurses in district hospitals. The study aimed to evaluate the knowledge, skills and attitudes of nurses regarding BLS in district hospitals in Cape Town, South Africa.

Methods: A multi-centre, observational cross-sectional study was conducted. An existing self-administered questionnaire was adapted and validated. Stratified quota sampling selected 243 nurses. Data were analysed using the Statistical Package for the Social Sciences.

Results: Only 3.0% of nurses scored above 80% on the knowledge test, while 15.9% scored that high on the skills test. Professional nurses, those with a bachelor’s degree, and nurses with any form of BLS training had significantly higher competency scores (p < 0.001). Basic life support certification rates were low at 50.8%, and certificates had expired in 52.5% of nurses. Furthermore, neither greater work experience (r = 0.025, p = 0.702) nor more frequent BLS performance (p = 0.083) was associated with higher competency scores.

Conclusion: Nurses working in district hospitals demonstrated positive attitudes, but they had insufficient knowledge and poor BLS skills.

Contribution: Nurses with higher-level qualifications and prior training in BLS achieved better competency scores. Attention should be directed towards CA registries, quality improvement systems, decentralised training at scale, performance management systems and an improved nurse staffing mix.