Factors Influencing Nurses’ Skills in Managing Resuscitation Patients: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.55123/sosmaniora.v4i4.6300Keywords:
CPR, Factor, Meta Analysis, Nursing Competence, Nursing SkillsAbstract
Cardiac arrest remains a major global health concern, and nurses' ability to perform effective cardiopulmonary resuscitation (CPR) is critical to patient survival. However, significant variations in CPR skills among nurses have been widely reported, influenced by factors ranging from individual characteristics to institutional support. This study aimed to systematically identify and analyze the factors influencing nurses’ competence in performing CPR. A systematic literature review and meta-analysis were conducted in accordance with PRISMA guidelines, utilizing databases such as PubMed, ScienceDirect, Springer, and Google Scholar to identify relevant articles published between 2021 and 2025. Ten studies met the inclusion criteria and were appraised using the JBI Critical Appraisal Checklist. The results indicated that knowledge, education, training, retraining, work experience, situational awareness, work environment, body mass index (BMI), and psychological factors contribute to variations in CPR proficiency. Nevertheless, the pooled meta-analysis revealed a very small and statistically insignificant effect size (0.0665; 95% CI: -0.0464 to 0.1794), with moderate heterogeneity (I² = 57.5%). Subgroup analysis showed that structured training had a more substantial positive effect compared to work experience. These findings suggest that experience alone is insufficient to ensure CPR competence. Therefore, standardized, recurrent training aligned with international guidelines and supported by adequate clinical infrastructure is essential to enhance nurses' resuscitation skills and improve emergency care outcomes.
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Alaryani, Z. D., Alhofaian, A., & Elhady, M. (2021). The relationship between knowledge and self-efficacy of nurses regarding early initiation of cardiopulmonary resuscitation and automated defibrillation in Saudi Arabia. Belitung Nursing Journal, 7(5), 387–394. https://doi.org/10.33546/bnj.1670
American Heart Assosciation. (2020). CPR and ECC Guildlines. Heart Assosciation.
Amoako-Mensah, E., Achempim-Ansong, G., Gbordzoe, N. I., Adofo, C. E., & Sarfo, J. O. (2023). Perceptions of nurses regarding quality of adult cardiopulmonary resuscitation in Ghana: A qualitative study. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01388-5
Araujo, N. R. D., Araújo, R. A. D., Moretti, M. A., & Chagas, A. C. P. (2022). Nursing training and retraining on cardiopulmonary resuscitation: A theoretical-practical intervention. Revista Da Escola de Enfermagem Da USP, 56. https://doi.org/10.1590/1980-220x-reeusp-2021-0521
Bashir, A., Ikhsan, M., & Nadira, D. (2025). FAKTOR-FAKTOR YANG MEMPENGARUHI KEMAMPUAN PERAWAT DALAM MENANGANI TINDAKAN LIFE SAVING PADA PASIEN DI RUANG IGD RSUD TGK CHIK DITIRO. 1.
Chik, M., Ahmad, A., Kunjukunju, A., Omar, M., Fariza, N., & Yusof, P. (2023). Knowledge and Practice of Cardiopulmonary Resuscitation (CPR) among Registered Nurses. Open Access Journal of Nursing, 6(2), 30–36. https://doi.org/10.22259/2639-1783.0602005
Dewi, K. Y., & Kanita, M. W. (2022). HUBUNGAN KESADARAN SITUASIONAL KEADAAN HENTI JANTUNG DENGAN SELF EFFICACY DALAM MELAKUKAN CPR DI RSUD Dr.MOEWARDI.
Ferrón‐Vivó, M., & Rupérez, M. J. (2024). Gender‐Based Differences in the Biomechanical Behavior of the Thorax During CPR Maneuvers. International Journal for Numerical Methods in Biomedical Engineering, 40(12), e3887. https://doi.org/10.1002/cnm.3887
Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230. https://doi.org/10.1002/cl2.1230
Hardiansyah, Y., Asikin, A. M., & Gowa, R. S. R. (2020). HUBUNGAN PENGETAHUAN PERAWAT TERHADAP PENANGANAN PASIEN GAWAT DARURAT DI RUMAH SAKIT LABUANG BAJI MAKASSAR. 1.
Heryadi, A. T., Mohtar, M. S., & Budi, I. (2024). PENGALAMAN PERAWAT DALAM TATALAKSANA RUJUKAN PASIEN DENGAN CARDIAC ARREST DI KABUPATEN HULU SUNGAI UTARA: STUDI FENOMENOLOGI. 6(2).
Heydari, F., Eghdami, K., Zamani, M., Golshani, K., & Masoumi, B. (2021). Evaluation of the effect of shift cycle time on chest compression quality during cardiopulmonary resuscitation. Tzu Chi Medical Journal, 33(3), 270–274. https://doi.org/10.4103/tcmj.tcmj_228_20
Higgins, J. P., & Green, S. (2020). Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series.
Hutabarat, V. (2022). HUBUNGAN PENGALAMAN LAMA BEKERJA PERAWAT DENGAN SELF EFFICACY DALAM MELAKUKAN TINDAKAN CPR. 14.
Juniana, M., & Subandi, A. (2022). Hubungan Pengetahuan Dengan Efikasi Diri Dalam Melakukan Resusitasi Jantung Paru Mahasiswa Jurusan Keperawatan Dan Kedokteran. 1.
Lubis, M. I. P. (2023). PENGARUH PELATIHAN BASIC LIFE SUPPORT BAGI TENAGA KESEHATAN DI LAYANAN PRIMER TERHADAP OUTCOME PASIEN GAWAT DARURAT. 6.
Mostafa, R., & El-Atawi, K. (2024). Strategies to Measure and Improve Emergency Department Performance: A Review. 16(1), 1–13. https://doi.org/DOI:%252010.7759/cureus.52879
Muthmainnah & Firman, Maulani. (2023). HUBUNGAN TINGKAT PENDIDIKAN TERHADAP KEPERCAYAAN DIRI PERAWAT DALAM MELAKUKAN CPR DI IGD RSD X. 2023, 4(2), 162–166. https://doi.org/10.33859/jni.v4i2
Nasution, D. N. R., & Nurhidayah, I. (2021). Faktor-Faktor yang Berhubungan Dengan Kesiapan Perawat Dalam Melaksanakan Resusitasi Jantung Paru Di IGD dan ICCU Rumah Sakit Umum Daerah Meuraxa Kota Banda Aceh Tahun 2020.
Nicolau, A., Jorge, I., Vieira-Marques, P., & Sa-Couto, C. (2024). Influence of Training With Corrective Feedback Devices on Cardiopulmonary Resuscitation Skills Acquisition and Retention: Systematic Review and Meta-Analysis. JMIR Medical Education, 10, e59720. https://doi.org/10.2196/59720
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, n71. https://doi.org/10.1136/bmj.n71
Rahmawati, D., Kusumajaya, H., & Anggraini, R. B. (2023). Faktor-faktor yang Berhubungan dengan Keterampilan Perawat dalam Tindakan Resusitasi Jantung Paru. Jurnal Penelitian Perawat Profesional, 5(2), 539–550. https://doi.org/10.37287/jppp.v5i2.1494
Ristanto, R. (2023). Correlation of Body Mass Index and The Ability to Perform High Quality Cardiopulmonary Resuscitation: Manikin Study. Babali Nursing Research, 4, 270–277. https://doi.org/10.37363/bnr.2023.42230
Sadeghi, A., Jahani, H., Senmar, M., Mehdipour, F., Mirzaei, A. R., Poorshivaee, A., & Hosseini, F. S. (2025). Barriers to the success of cardiopulmonary resuscitation teams in emergency departments: A perspective from nurses. BMC Emergency Medicine, 25(1), 85. https://doi.org/10.1186/s12873-025-01245-5
Seran, A. N., Prasetyo, J., Uly, R. G. Z., & Kiri, H. A. (2024). FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PENERAPAN CODE BLUE SISTEM OLEH PERAWAT. 16(4).
Shao, F., Xu, S., Ma, X., Xu, Z., Lyu, J., Ng, M., Cui, H., Yu, C., Zhang, Q., Sun, P., & Tang, Z. (2020). In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China. Resuscitation, 151, 18–23. https://doi.org/10.1016/j.resuscitation.2020.04.005
Sheth, V., Chishti, I., Rothman, A., Redlener, M., Liang, J., Pan, D., & Mathew, J. (2020). Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City. Resuscitation, 155, 3–5. https://doi.org/10.1016/j.resuscitation.2020.07.011
Tomas, N., & Kachekele, Z. A. (2023). Nurses’ Knowledge, Attitudes, and Practice of Cardiopulmonary Resuscitation at a Selected Training Hospital in Namibia: A Cross-Sectional Survey. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231216809
Tsima, B. M., Rajeswaran, L., & Cox, M. (2019). Assessment of cardiopulmonary resuscitation equipment in resuscitation trolleys in district hospitals in Botswana: A cross-sectional study. African Journal of Primary Health Care & Family Medicine, 11(1). https://doi.org/10.4102/phcfm.v11i1.2029
World Health Organization. (2021). Cardiovascular Disease.
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