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8/13/2019 101313 - Chapter II
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CHAPTER II
REVIEW OF RELATED LITERATURE
This chapter includes studies and articles regarding the different issues associated
with the study taken locally and internationally. This is divided into four parts: the
annotated review, synthesis, conceptual framework, and paradigm.
Socio-demographic Profile
Age
Sun Coast Hospital Pharmacy. (2010). AgeSpecif ic Competencies and Skill s. USA:
Sun Coast Pharmacy
According to Sun Coast Hospital Pharmacy, age-specific competencies are skills
that you use to give care that meets each patients unique needs. Understanding these
stages of life is the key to age-specific competencies.
Young adults reach physical and sexual maturity. Muscular efficiency is at its
peak between the ages of 20-30; Growth of skeletal system continues until age 30, some
experience loss in hearing, especially high tones. Young adults mental abilities reach its
peak during their twenties; reasoning skills, information recall, verbal skills are used to
solve problems. In regards to communication, one must be supportive and honest and
respect personal values. Watch body language as a cue for feelings.
Adults continue to decline in physical abilities and are at increasing risk for
chronic illness and major health problems. They continue to learn and their memory skills
and/or speed of learning may decline. Confusion often signals illness or a medication
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problem. Expression of feelings, thoughts, avoiding despair, using humor, and staying
positive are highly encouraged for this age group.
As middle adults begin to age, there is decreased muscle strength and mass.
Without regular exercise their endurance declines. Middle adults use life experiences to
learn, create, and solve problems. They hope to contribute to future generations, keep a
hopeful attitude and focus on strengths, not limitations.
As older adults age gradually, there is a natural decline in some physical abilities
and senses. They continue to be active learners and thinkers. Their memory skills may
start to decline. One must give respect, prevent isolation and encourage acceptance of
aging.
The article states that in different age group, they have individualized level of
knowledge and different acquisition of skills based on their level of understanding. The
article also includes that in every age group there are different factors that could affect
the ways on how they accept a new learning and there are also challenges that could
hinder the acceptance of the new knowledge.
This literature was utilized in the analysis and interpretation of the study.
Gender
Rogers, K. (2010). Who have better memories: Men or Women? Retrieved last
September 19, 2012 from http://www.britannica.com/blogs/2008/02/who-has-
a-better-memory-man-or-woman/
Women have the upper hand in storing and recalling verbal episodic memories,
whereas men have the upper hand in storing and recalling visuospatial episodic
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memories. Scientists have also discovered that women are very adept at remembering the
faces of strangers and nearly anything associated with emotion, which may or may not be
stored as episodic memory.
This literature was utilized in analysis and interpretation of the study.
Salthouse, R. (2008). Understanding Human Development: Dialogues with L if espan
Psychology.Dordretch, The Netherlands; Kluwer Academic Publishers
Age differences are reduced in tasks with moderate to large knowledge
involvement not because of changes in the predictive value of different factors at
different ages but because the average level of one performance determinant (knowledge)
tends to increase with age at the same time that the average level of the other
performance determinant (speed) tends to decrease.
This literature was utilized in analysis and interpretation of the study.
Highest Educational Attainment
Labiad, N. (2013). Educational Attainment and Learni ng Outcomes: Implications for
Youth in Labour Market.Lombard, Italy: University of Bergamo.
Completing a school year successfully does not guarantee that certain skills and
knowledge is acquired or learned. For example, learning outcomes of 15 years of
education is not the same in a country with generally high quality of education and in one
with lower quality education. Therefore, the question of quality of learning is invaluable;
one way to measure such quality in education is the assessment of learning outcomes.
The educational attainment indicator needs to be accompanied by the assessment of
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learning outcomes. In other words, in addition to considering what is studied and for how
long, we should consider what is learned and how well it is learnt.
This literature was utilized in the analysis and interpretation of the study.
Education Policy and Data Center (2012). L iteracy and Educational Attainment.
Connecticut Ave. NW Washington, DC 20009-5721Literacy levels and educational attainment serve as indicators of the knowledge
and skills that a population possesses. While indicators of literacy and educational
attainment both capture information about the human capital resources of a population,
caution should be used with educational attainment levels which, unlike literacy, do not
necessarily testify to mastery of a particular skill or provide information about the quality
of education achieved.
This literature was utilized in analysis and interpretation of the study.
Barangay Health Worker
Department of health. (2011). What is a Barangay Health Worker? Retrieved last
October 11, 2013 from http://www.doh.gov.ph/content/what-barangay
-health-worker.html
According to Republic Act No. 7883 otherwise known as "The Barangay Health
Workers' Benefits and Incentives Act of 1995," In Section 3 the term barangay health
workers is defined as to a person who has undergone training programs under any
accredited government and non-government organization and who voluntarily renders
primarily health care services in the community after having been accredited to function
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as such by the local health board in accordance with the guidelines promulgated by the
Department of Health (DOH).
A Barangay Health Worker is qualified to provide primary health care services in
the community it is serving based on the guidelines given by the (DOH) such as: giving
of first aid, equipment sterilization, assisting in health center activities, collecting vital
statistics, maintaining records and making reports, participating in community meetings,
assisting in nutrition education, monitoring and feeding, assisting in immunization
education, monitoring, and dispensing, assisting in family planning services and assisting
in sanitation and hygiene promotion and education.
In recognition of their services, all accredited BHWs who are actively and
regularly performing their duties shall be entitled to the following incentives and benefits:
Hazard Allowance for BHWs exposed to situations, conditions or factors in the work
environment or place where foreseeable or unavoidable danger or risks exist which
adversely endanger his health or life and/or increase the risk of producing adverse effect
on his person in the exercise of his duties, to be validated by the proper authorities in an
amount to be determined by the Local Health Board and the local peace and order council
of the LGU concerned; Subsistence allowance for BHWs whom render service within the
premises of isolated barangay health stations (BHS)in order to make their services
available at any and all times equivalent to the meals they take in the course of their duty
computed in accordance with the prevailing circumstances as determined by the LGU
concerned; Training and education and career enrichment programs (TECEPS)-the DOH
in accordance with the Department of Education, and other concerned agencies and non-
government organizations shall provide opportunities for the following: educational
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programs which shall recognize years of primary health care service as credits to higher
education in institutions with stepladder curricula that will entitle BHWs to upgrade their
skills and knowledge for community work or to pursue further training as midwives,
pharmacists, nurse or doctors, continuing education, study and exposure tours, training,
grants, field immersion, scholarships, scholarship benefits in the form of tuition fees
instate colleges to be granted to one child of every BHW who will not be able to avail of
the above programs; and special training programs such as those on traditional medicine,
disaster preparedness and other programs that address emergent community health
problems and issues; Civil service eligibility a second grade eligibility shall be granted to
BHWs who have rendered (5) years continuous service as such, provided that should the
BHW become a regular employee of the government, the total number of years served as
BHW shall be credited to his/her service in computing retirement benefits; Free legal
services legal representation and consultation services shall be immediately provided by
the Public Attorneys Office (PAO) in cases of coercion, interference, and in other civil
and criminal cases filed by or against BHWs arising out of or in connection with the
performance of their duties as such; and Preferential access to loan the agencies
providing loan services will set aside one per cent (1%) of their loanable funds for
organized BHW groups that have community-based income generating projects in
support of health programs or activities.
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Cardiopulmonary Resuscitation
Body Parts and Functions
National Heart Lung and Blood Institute. (n.d.). How the Heart Works. Retrieved
last August 20, 2013 from http://www.nhlbi.nih.gov/health//dci/Diseases
/hhw/hhw_all.html
The heart is a muscular organ that acts like a pump to continuously send blood
throughout your body. It is at the center of the circulatory system. This system consists of
a network of blood vessels, such as arteries, veins, and capillaries. These blood vessels
carry blood to and from all areas of the body. An electrical system regulates the heart and
uses electrical signals to contract the heart's walls. Blood is pumped into the circulatory
system upon contraction of the walls of the heart. A system of inlet and outlet valves in
the heart chambers work to ensure that blood flows in the right direction. Heart is vital to
health and nearly everything that goes on in the body. Without the heart's pumping
action, blood cannot circulate within the body. Blood carries the oxygen and nutrients
that your organs need to work normally. Blood also carries carbon dioxide, a wasted
product, to your lungs to be passed out of the body and into the air.
This literature was utilized to formulate the questionnaire.
Rosenberger, E. (2009). The Functions of Red Blood Cell s. Retrieved last August
20, 2103 from http://www.helium.com/items/763669-the-functions-of-red-
blood-cells
http://www.nhlbi.nih.gov/health/dci/Diseases%20/hhw/hhw_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases%20/hhw/hhw_all.htmlhttp://www.helium.com/items/763669-the-functions-of-red-blood-cellshttp://www.helium.com/items/763669-the-functions-of-red-blood-cellshttp://www.helium.com/items/763669-the-functions-of-red-blood-cellshttp://www.helium.com/items/763669-the-functions-of-red-blood-cellshttp://www.helium.com/items/763669-the-functions-of-red-blood-cellshttp://www.nhlbi.nih.gov/health/dci/Diseases%20/hhw/hhw_all.htmlhttp://www.nhlbi.nih.gov/health/dci/Diseases%20/hhw/hhw_all.html8/13/2019 101313 - Chapter II
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Red blood cells, known also as RBCs, have several important roles to play in the
body. The primary function of red blood cells is to carry oxygen from the lungs to the
tissues around the body. As a secondary function, it is also a key player in getting waste
carbon dioxide from tissues to the lungs, where it can be breathed out. A typical RBC is
about 6-8 micrometers in diameter, about the same as the width of a spider web strand.
An RBC is biconcave in shape. The oxygen carried in the red blood cells is stored in a
special protein known as hemoglobin.
This literature was utilized to formulate the questionnaire.
Pew Research Center (2013). Publics Knowledge of Science and Technology.
Retrieved last September 7, 2013 from http://www.people-
press.org/2013/04/22/publics-knowledge-of-science-and-technology/
A study done by Pew Research Center about the publicsknowledge of Science
and Technology states that about 7 out of 10 respondents, who have finished education
from high school graduate to college graduate, know that the basic function of red blood
cells is to carry oxygen to all parts of the body.
This literature was utilized in the analysis and interpretation of the study.
Pollak, A. (2011). Emergency Care and Transportati on of the Sick and I njur ed (10th
ed.). Canada: Jones and Bartlett Publishers
Perfusion is the delivery of blood and oxygen and other essential nutrients to the
bodys cells to keep them alive. While delivering these essential components to the
bodys cells, waste products such as carbon dioxide are removed from the cell and
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eliminated from the body. Adequate perfusion is the responsibility of the perfusion
triangle, which consists of three essential components: a functioning pump (the heart),
adequate volume (the blood and water), and an intact container (the blood vessels).
This literature was utilized to formulate the questionnaire.
University of Rochester Medical Center. (2013). Respirator y System. Retrieved last
August 20, 2013 from
http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID
=90&ContentID=P02408
The lungs take in oxygen, which the body's cells need to live and carry out its
normal functions. The lungs also get rid of carbon dioxide, a waste product of the cells.
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They
take up most of the space in the chest, or the thorax (the part of the body between the
base of the neck and diaphragm). The lungs are enveloped in a membrane called the
pleura.
This literature was utilized to formulate the questionnaire.
Des Jardins, T. (2008). Cardiopulmonary Anatomy & Physiology: Essentials for
Respir atory Care (5th e.d.). USA: Delmar Cengage Learning
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The term ventilation is defined as the process that moves gases between the
external environment and the alveoli. It is the mechanism by which oxygen is carried
from the atmosphere to the alveoli and by which carbon dioxide (delivered to the lungs in
mixed venous blood) is carried from the alveoli to the atmosphere.
This literature was utilized to formulate the questionnaire
Definition
Knoop, K. et al. (2012). Atl as of Emergency Medicine (2nd ed.). New York, USA:
McGraw Hill
According to Knoop, Cardiopulmonary Resuscitation (CPR) is a procedure to
support and maintain breathing and circulation for an infant, child, or adolescent who has
stopped breathing (respiratory arrest) and/or whose heart has stopped (cardiac arrest).
CPR is part of the emergency cardiac care system designed to save lives. Many deaths
can be prevented by prompt recognition of cardiopulmonary arrest and notification of the
emergency medical system (EMS), followed by early CPR,defibrillation (which delivers
a brief electric shock to the heart in attempt to get the heart to beat normally), and
advanced cardiac life support measures. When performed by a layperson, CPR is
designed to support and maintain breathing and circulation until emergency medical
personnel arrive and take over. When performed by healthcare personnel, it is used in
conjunction with other basic and advanced life support measures. CPR must be
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performed within four to six minutes after cessation of breathing to prevent brain damage
or death. CPR consists of rescue breathing, which delivers oxygen to the victim's lungs,
and external chest compressions, which help circulate blood through the heart to vital
organs. In this article, cardiopulmonary resuscitation is basically a procedure to restore
the breathing or circulation of the victim. Rescue breathing, which provides oxygen to a
person's lungs and chest compressions, which keep the person's blood circulating are
performed in CPR. CPR can be lifesaving, but it is best performed by those who have
been trained in an accredited CPR course.
This literature was utilized to formulate the questionnaire.
Berg, R. et. al. (2010). American Heart Association Guideli nes for Cardiopulmonary
Resuscitation and Emergency Cardiovascular Care Science. Retrieved last
August 20, 2013 from http://circ.ahajournals.org/content/122/18_supplfull
Recognition of cardiac arrest is not always straightforward, especially for
laypersons. Any confusion on the part of a rescuer can result in a delay or failure to
activate the emergency response system or to start CPR. Precious time is lost if
bystanders are too confused to act. Therefore, these adult BLS Guidelines focus on
recognition of cardiac arrest with an appropriate set of rescuer actions. Once the lay
bystander recognizes that the victim is unresponsive, that bystander must immediately
activate or send someone to activate the emergency response system. Once the healthcare
provider recognizes that the victim is unresponsive with no breathing or no normal
breathing such as gasping, the healthcare provider will activate the emergency response
system. After activation, rescuers should immediately begin CPR.
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Early CPR can improve the likelihood of survival, and yet CPR is often not
provided until the arrival of professional emergency responders. Chest compressions are
an especially critical component of CPR because perfusion during CPR depends on these
compressions. Therefore, chest compressions should be the highest priority and the initial
action when starting CPR in the adult victim of sudden cardiac arrest. The phrase push
hard and push fast emphasizes some of these critical components of chest compression.
High-quality CPR is important not only at the onset but throughout the course of
resuscitation. Early CPR can improve the likelihood of survival, and yet CPR is often not
provided until the arrival of professional emergency responders. Chest compressions are
an especially critical component of CPR because perfusion during CPR depends on these
compressions. Therefore, chest compressions should be the highest priority and the initial
action when starting CPR in the adult victim of sudden cardiac arrest. The phrase push
hard and push fast emphasizes some of these critical components of chest compression.
High-quality CPR is important not only at the onset but throughout the course of
resuscitation.
This literature was utilized to formulate the questionnaire.
Larmon, B., et al. (n.d). Basic L if e Support Skil ls. Toronto, Canada: Prentice Hall
According to Larmon, the steps in CPR (compressions, airway, and breathing)
should be used whenever someone is not breathing and when the heart is not beating.
After two rescue breaths are given, 30 chest compressions should be started right away.
Someone can stop breathing and/or have cardiac arrest from: heart attacks, strokes (when
the blood flow to a part of the brain suddenly stops), choking on something that blocks
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the entire airway near-drowning incidents (when someone is underwater for too long and
stops breathing), a very bad neck, head, or back injury, severe electrical shocks (like from
touching a power line), very sick from a serious infection, too much bleeding,
severeallergic reactions, swallowing a drug or chemical.
In this article, CPR is done to patients usually with heart attack. CPR promotes
airway, breathing and circulation. CPR is not for patients without signs of life or when
the brain matters are exposed from inside out, and are decapitated.
This literature was utilized to formulate the questionnaire.
American Heart Association. (2012). BLS for H ealthcare Providers. Texas, Dallas:
American Heart Association
The American Heart Association (AHA) has adopted, supported, and helped
develop the concept of emergency cardiovascular care (ECC) for many years. The term
Chain of Survival provides a useful metaphor for the elements of the ECC systems
concepts. The five links in the adult Chain of Survival are: Immediate recognition of
cardiac arrest and activation of the emergency response system; Early cardiopulmonary
resuscitation (CPR) with an emphasis on chest compressions; Rapid defibrillation;
Effective advance life support and Integrated post cardiac arrest care. Although basic life
support is taught as a sequence of distinct steps to enhance skills retention and clarify
priorities, several actions should be accomplished simultaneously when multiple rescuers
are present.
The 2010 American Heart Association Guidelines for Cardiopulmonary
Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) recommend a change in
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the basic life support sequence of steps from A-B-C (Airway, Breathing, Chest
compressions) to C-A-B (Chest compressions, Airway, Breathing) for adults, children,
and infants. The change in CPR sequence requires reeducation of everyone who has ever
learned CPR. This was done to improve survival rates of the victims.
In the A-B-C sequence, chest compressions were often delayed while the rescuer
opened the airway to give mouth to mouth breaths, retrieved a barrier device, or gathered
and assembled ventilation equipment. By changing the sequence to C-A-B, rescuers can
start chest compressions sooner, and the delay in giving breaths should be minimal.
This literature was utilized to formulate the questionnaire.
Chris (2011). CPR Guidelines for American Heart Association and American Red
Cross. Retrieved last October 11, 2013 from
http://inhomecpr.com/in_home_cpr_news/cpr-guidelines-for-american-
heart-association-and-american-red-cross/
American Heart Association
1) Make sure the scene is safe before approaching the victim; 2) Check to see if the
person responds by tapping the victim and shouting, Are you OK?; 3) If the person
doesnt respond, get help. Have you and someone else call 911 and get an AED
(automated external defibrillator) if available; 4) Check for breathing. The breathing
should be normal, not gasping. If the person is not breathing or only gasping, they need
CPR; 5) Begin CPR with 30 chest compressions. Push down at least 2 inches. The rate
of compressions is at least 100 compressions a minute. After each compression let the
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chest come back up to its normal position; 6) Open the airway with a head tilt-chin lift
and give 2 breaths; 7) Continue giving 30 compression and 2 breaths until the person
starts to respond, you are too exhausted to continue, the scene becomes unsafe, an AED
arrives or EMS (Emergency Medical Services) arrives.
American Red Cross
1) Make sure the scene is safe before approaching the victim; 2) Check to see if the
person responds by tapping the victim and shouting, Are you OK?; 3) If the person
doesnt respond, get help. Have you and someone else call 911 and get an AED
(automated external defibrillator) if available; 4) Check for breathing by performing a
head tilt-chin lift. Look, listen and feel for breathing for no more than 10 seconds.
Occasional gasps are not breathing; 5) quickly scan for severe bleeding; 6) Begin CPR
with 30 chest compressions. Push down at least 2 inches for an adult. The rate of
compressions is at least 100 compressions a minute. After each compression let the chest
come back up to its normal position; 7) Open the airway with a head tilt-chin lift and give
2 breaths; 8) Continue giving 30 compression and 2 breaths until you find an obvious
sign of life, you are too exhausted to continue, the scene becomes unsafe, an AED arrives
or EMS (Emergency Medical Services) arrives.
Differences: The primary difference is how breathing is assessed. The AHA has
eliminated, look, listen and feel for breathing from its guidelines. The responder
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checks for breathing, but how this is done is not specifically stated. The ARC still
instructs, Look, listen and feel for breathing.
The ARC continues to include the step of quickly scanning for severe bleeding
after checking for breathing. The AHA does not include this step.
Indication
Berg, R.A. et. al. (2010). Part 5: Adul t basic l if e support: 2010 American H eart
Association Guidelines for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care. Circulation
According to the author, if a lone rescuer finds an unresponsive adult or witnesses
an adult who suddenly collapses, after ensuring that the scene is safe, the rescuer should
check for a response by tapping the victim on the shoulder and shouting at the victim.
The trained or untrained bystander should activate the emergency response system. After
activation of the emergency response system, all rescuers should immediately begin CPR.
Checking for pulse needs to be performed first. It should not take the rescuer
more than ten seconds to check for pulse. When no pulse is felt within that time period,
chest compressions must be performed. Effective chest compressions are essential for
providing blood flow during CPR. Providing effective chest compressions means you
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must push hard and push fast. It is reasonable for laypersons and healthcare providers to
compress the adult chest at a rate of at least 100 compressions per minute with a
compression depth of at least 2 inches/5 cm. Rescuers should attempt to minimize the
frequency and duration of interruptions in compressions to maximize the number of
compressions delivered per minute. A compression-ventilation ratio of 30:2 is
recommended.
Assuming the person has a pulse and is breathing, the recovery position means
placing the person on his or her side. This allows for the person not to choke on saliva
and helps keep the airway open. The downside arm may be raised to support the head.
This literature was utilized to formulate the questionnaire.
Abe, T. (2011). Time-Based Partitioning Model for Predicting Neurologically
Favorable Outcome among Adults with Witnessed Bystander Out-of-H ospital
CPA. Retrieved last August 19, 2013 from
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0
028581
When an adult suddenly collapses, whoever is nearby should activate the
emergency system and begin chest compressions (regardless of training). Trained lay
rescuers who are able and healthcare providers should provide compressions and
ventilations. Contrary to the belief of too many in this situation, CPR is not harmful.
Inaction is harmful and CPR can be lifesaving. However, the quality of CPR is critical.
Chest compressions should be delivered by pushing hard and fast in the center of the
chest or sternum and should be of adequate rate and depth. Rescuers should allow
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complete chest recoil after each compression and minimize interruptions in chest
compressions. They should also avoid excessive ventilation. If and when available, an
automated external defibrillator (AED) should be applied and used without delaying
chest compressions. With prompt and effective provision of these actions, lives are saved
every day.
This literature was utilized to formulate the questionnaire.
American Heart Association. (2013). Hands-Only CPR. Retrieved last September 1,
2013 from http://www.heart.org/HEARTOR/CPRAndECC/HandsOnlyCPR/
/LearnMore_UCM_440810_jsp
Continue to provide hard and fast chest compressions with minimal interruptions
to the best of ability. Giving high-quality chest compressions at least 100 times per
minute is hard work. Most people will get tired after only a few minutes of delivering any
type of CPR. If someone else is nearby, ask that person to take over chest compressions
after about two minutes, or about 200 compressions.
Continue pushing hard and fast in the center of the chest until help arrives. If the
victim speaks, moves, or breathes normally while youre giving chest compressions,
hands-only CPR can be stopped.
This literature was utilized to formulate the questionnaire.
Related Studies
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Anderson, G. et al. (2009). CPR and F ir st Aid Skil l Retention Scandinavian Jour nal
of Trauma, Resuscitation and Emergency Medicine. Retrieved last February 8,
2013 from http://www.worksafebc.com/contact_us/research/es01470.asp
This study states that many necessary skills of CPR and first aid are forgotten
shortly after certification in laypersons. The purpose of this study is to determine the
decline in first aid and CPR skills and knowledge to those who are required to respond to
emergency situations within workplaces.
There is a reduction in CPR skills and knowledge, and is most likely influenced
by the repetition of training in those that had recertified their first aid one or more times.
First aid and CPR skill-based components appeared to deteriorate in a more predictable
fashion following training. In the choking scenario, skill in compressions after the victim
became unconscious showed deterioration after 30 days. In the CPR scenario, poor
performance of skills was linked to time since last training for correctly land marking for
chest compressions; controlling the airway for ventilations; a pre-CPR safety check
variable; periodic checks for breathing, head positioning, and patient placement; and,
number of chest compressions for CPR cycles one to four. Skills such as hand placement
and abdominal thrusts in the choking scenario and number of compressions and
ventilations attempted in CPR cycle five to eight were performed poorly since last
training.
The results of the study suggest that repetition may be more important to skill and
knowledge retention than the length of time since the last training. Strategies for
increasing the repetition of the skills and knowledge should be explored. Many skills
deteriorate rapidly over the course of the first 90 days.
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This literature was utilized in the analysis and interpretation of the study.
Josipovic, P. et al. (2009). Basic li fe support knowledge of undergraduate nursing and
chir opractic students. Australian Journal of Advanced Nursing, 26(4), 58-63
The aim of this study was to examine retention of CPR/BLS knowledge of third
year nursing and fourth year chiropractic students following instruction and assessment
of CPR/BLS skills and knowledge as part of their undergraduate degree program. The
design of the study was non experimental exploratory survey to determine perceived
ability and knowledge of CPR/BLS following completion of CPR/BLS instruction. The
result showed that majority of students (78%) felt they were well prepared to perform
CPR/BLS. However, there were deficiencies in both groups with regards to knowledge of
current guidelines. Chiropractic students were less likely to identify the correct
compression rate compared to the nursing group (Spearmans rho 0.669, p.001) with
95% of the chiropractic students not able to identify the correct rate. Nursing students
scored themselves highly for self-rated knowledge and ability to perform CPR.
Chiropractic students tended to score themselves at a lower rating in these areas than the
nursing students; however the differences were not statistically significant.
This literature was utilized in the analysis and interpretation of the study.
Oermann, M. (2010). Professor Oermanns Nursing Study Points to Changing the
Way We Teach CPR. Retrieved last December 23, 2012 from
http://nursing.unc.edu/news-events/items?tag=Marilyn%20Oermann
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The chances for patient survival are improved with immediate and high quality
CPR, making it an especially important skill for nurses, who are often the first responders
to cardiac arrests in hospitals. The results of this study provide evidence for how nursing
students and other health providers can maintain their basic life support (BLS) skills.
Staff nurses and other health care professionals were also included in this large
interdisciplinary study.
The study began in 2008 wherein different approaches to teaching and learning
BLS were tested by students at 10 schools of nursing with associate, diploma, or
baccalaureate programs. Students who practiced their CPR psychomotor skills on voice
advisory mannequins for only six minutes a month either maintained or improved their
skills over the 12-month period. Students who did not practice beyond their initial BLS
training had a significant loss of skills, some as early as three months after completing it.
This literature was utilized in the analysis and interpretation of the study.
Sharma, R., Attar, N. (2012). Adult Basic Life Support (BLS) Awareness and
Knowledge among Medical and Dental I nterns Completing Internship from
Deemed University. Deralakatte, Mangalore: Nitte University Journal of
Health Science
A descriptive study was conducted by using a questionnaire comprising of 19
questions to collect the data pertaining to demographic details, awareness and knowledge
of BLS, attitude towards BLS among all the medical and dental interns. As a conclusion
of the study: Performing BLS and attending BLS work shop plays a vital role in attaining
BLS knowledge by both medical and dental interns. There is an absolute clear need for
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review of basic life support (BLS) education. There is a need for structured training of
BLS and BLS must be included in the medical and dental academic curriculum. This
will go a long way in improving the outcome of BLS delivery by interns (the future
health care providers), thus immensely benefitting the society and also boosting the
morale of the interns from both medical and dental streams.
This literature was utilized in the analysis and interpretation of the study.
Rice, K. (2013). American Safety & Health I nstitute: CPR Skill s Retention Help
Your Students Remember. Retrieved last August 20, 2013 from
http://www.hsi.com/Blog/bid/98743/CPR-Skills-Retention-Help-Your-
Students-Remember
According to this author, CPR, AED, and first aid skills are often forgotten as
time passes. The more we forget, the less likely we are to have the confidence to respond
in an emergency.
The Occupational Safety and Health Administration (OSHA) put it this way:
First-aid responders may have long intervals between learning and using CPR and AED
skills. Numerous studies have shown a retention rate of 6-12 months of these critical
skills. The American Heart Associations Emergency Cardiovascular Care Committee
encourages skills review and practice sessions at least every 6 months for CPR and AED
skills. Instructor-led retraining for life-threatening emergencies should occur at least
annually. Retraining for non-life-threatening response should occur periodically.
The key to skills retention is being re-exposed again to course content. A
randomized trial of participants in a public access defibrillation program was done in
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2008 and was published inResuscitation.Three trial groups were retested at either 6 or
12 months after their initial training and it was found that skill retention decreased
significantly in the three groups and was lowest after 12 months if no 6-month retests
were done. In trainees who did undergo retesting at 6 months, skills did not deteriorate at
12 months.
This literature was utilized in the analysis and interpretation of the study.
Johnston, T.C., Clark, M.J., Dingle, G.A., & Sanders, E.L . (n.d). Levels of cardiac
knowledge and cardiopulmonary resuscitati on train ing among older people in
Queensland. Australasian Journal on Ageing, 23(2), 91-96
The aim of the study was to determine levels of cardiac knowledge and
cardiopulmonary resuscitation (CPR) training in older people in Queensland, Australia.
The study was done through a telephone survey of 4,490 adults which examined the
knowledge of the respondents regarding coronary heart disease risk factors, heart attack
symptoms, as well as respondentsrates and recency of training in CPR.
Older participants, aged 60 years and over, were approximately one and a half
times more likely than the 3039 year-old reference group to have limited knowledge of
heart disease risk factors (OR = 1.53), and low knowledge of heart attack symptoms
(OR = 1.60). Older participants had significantly lower rates of training in CPR, with
almost three quarters (71.7%) reporting that they had never been trained. Older people
who had completed CPR training were significantly less likely to have done so recently.
This literature was utilized in the analysis and interpretation of the study.
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Custers, E.J. (2008). Long Term Retention of Basic Science Knowledge: A Review
Study. Retrieved last September 21, 2013 from
http://www.ncbi.nlm.nih.gov/pubmed/18274876
A review of long-term retention of basic science knowledge is presented. First, it
is argued that retention of this knowledge has been a long-standing problem in medical
education. Next, three types of studies are described that are employed in the literature to
investigate long-term retention of knowledge in general. Subsequently, first the results of
retention studies in general education are presented, followed by those of studies of basic
science knowledge in medical education. The results of the review, in the general
educational domain as well as in medical education, suggest that approximately two-third
to three-fourth of knowledge will be retained after one year, with a further decrease to
slightly below fifty percent in the next year. Finally, some recommendations are made for
instructional strategies in curricula to improve long term retention of the subject matter
dealt with.
This literature is used in the analysis and interpretation of data.
Broomfield, R. (n.d). A Quasi-Exper imental Research to I nvestigate the Retenti on of
Basic Cardiopulmonar y Resuscitation Skil ls and Knowledge by Qual if ied
Nurses Fol lowing a Course in Professional Development.Middlesbrough,
England: University of Teesside College of Health
The research was undertaken with the intention of testing six null hypotheses
regarding the retention of basic cardiopulmonary resuscitation (CPR) skills and
knowledge of registered nurses. The hypotheses were formulated from the broad aims of
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the research, which were to investigate conclusions reached by other researchers
highlighting the speed with which retention of CPR skills and knowledge deteriorates,
and to investigate the need for regular updating in CPR. The research was quasi-
experimental in nature. The findings of the research reflect similar results to previous
research undertaken and discussed in the literature review, suggesting that retention of
skills and knowledge quickly deteriorates if not used or updated regularly. Therefore this
research supports the importance of CPR refresher courses on a regular basis.
Synthesis
Knoop defined Cardiopulmonary Resuscitation (CPR) as a procedure that
supports and maintain breathing and circulation for an infant, child, or adolescent who
has stopped breathing or whose heart has stopped. AHA and Hemphil, recommended
changes such as the sequencing of steps from A-B-C (Airway, Breathing, Compression)
to C-A-B (Compression, Airway, Breathing) and to start CPR with 30 compressions
rather than 2 ventilations that would lead to improved outcomes. Steps on performing
CPR was expounded by Abe and Berg if a lone rescuer finds an unresponsive adult, after
ensuring that the scene is safe, the rescuer should check for a response by tapping the
victim on the shoulder and shouting at the victim. Bystander should activate the
emergency response system. After activation of the emergency response system, all
rescuers should immediately begin CPR. Larmon enumerated the possible scenarios to
perform CPR such as someone who stop breathing or have cardiac arrest.
Sun coast hospital pharmacy explained age groups and their specific
competencies ad skills. Roger explained that men have storing and recalling on
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visuospatial episodic while women have in storing and recalling verbal episodic
memories. Labiad study showed that completing a school year successfully does not
guarantee that certain skills and knowledge is acquired or learned. What is studied and
for how long should be considered and also what is learned and how well it is learnt.
According to Education Policy and Data Center, literacy levels and educational
attainment serve as indicators of the knowledge and skills that a population possesses
For the related studies that would support the analysis of the data. Anderson
suggested that repetition may be more important to skill and knowledge retention than the
length of time since the last training. Oermann, Sharma & Rice agreed that there should
be continuous training. Josipovic suggested that there should be a standard training and
updates to CPR trainings.
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Conceptual Framework
This study is based on Jerome Bruners Constructivist theoretical framework,
wherein learners engage in discovery learning, obtaining knowledge by themselves. They
select and transform information, construct hypotheses, and make decisions, relying on a
cognitive structure to do so. In order for discovery to occur learners require background
preparation in the form of a cognitive structure that provides meaning and organization to
experiences and allows the individual to "go beyond the information given". Bruner's
framework is based on the theme that learners construct new ideas or concepts based
upon existing knowledge. Learning is an active process. Facets of the process include
selection and transformation of information, decision making, generating hypotheses, and
making meaning from information and experiences.
Bruner's theories emphasize the significance of categorization in learning. "To
perceive is to categorize, to conceptualize is to categorize, to learn is to form categories,
to make decisions is to categorize." Interpreting information and experiences by
similarities and differences is a key concept.
Bruner emphasized teaching as a means of enhancing cognitive development,
hence the task of the teacher is to translate information to be learned into a format
appropriate to the learner's current state of understanding. The instructor should try and
encourage students to discover principles by themselves, and both learners and teachers
should engage in an active dialog, also known as Socratic learning. Curriculum should be
organized in a spiral manner so that the student continually builds upon what they have
already learned.
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Bruners work circled around four key themes. First is where Bruner emphasized
the role of structure in learning and how it may be made central in teaching. The second
key theme is where he introduced the ideas of readiness for learning and spiral
curriculum. Bruner believed that any subject could be taught at any stage of development.
Spiral curriculum refers to the idea of revisiting basic ideas over and over, building upon
them and elaborating to the level of full understanding and mastery. The third theme
states that intuitive and analytical thinking should both be encouraged and rewarded. And
lastly, Bruner focused on the learners motivation when it comes to learning. He felt that
ideally, interest in the subject matter is the best stimulus for learning.
Level of Knowledge refers to the scores that the barangay health workers obtained
in answering the researcher made questionnaire; grouped as definition, indication,
method and body parts and functions.
Body Parts and Functions is a component of the level of knowledge on CPR
which refers to statements describing parts of the human body, its purpose and its
relevance when performing Cardiopulmonary Resuscitation; Definition is a component of
the level of knowledge on CPR which refers to statements which explain the meaning,
concept and process of Cardiopulmonary Resuscitation; Method is a component of the
level of knowledge on CPR that refers to statements which explains the series of steps or
actions in performing correct Cardiopulmonary Resuscitation; Indication is a component
of the level of knowledge on CPR that refers to statements which specifies or suggests
the instances where there is a need to perform Cardiopulmonary Resuscitation.
Barangay health worker refers to the frontline health care worker who was trained
under the health department of the local government and/or the Department of Health; the
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barangay health workers are mainstays in the barangay health center where they provide
basic health care services to their respective constituents.
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Conceptual Paradigm
Figure 1. Conceptual Paradigm. Level of Knowledge on Cardiopulmonary
Resuscitati on of the Barangay Health Workers in a selected district i n M akati.
Socio-demographic
Profile
Age
Gender
Highest
educationalattainment
Occupation
Previous basic lifesupport training
attended
Level of Knowledge as to
Components
Body parts and functions
Definition
Indication Method
Level of
Knowledge as to
Very High Level
of Knowledge
High Level of
Knowledge
Moderate Level
of Knowledge
Low Level of
Knowledge
Very Low Level
of Knowledge
No Knowledge
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