IJCS | Volume 33, Nº2, March / April 2020

172 Novaes Neto & Freitas Factors associated to knowledge of cardiac arrest Int J Cardiovasc Sci. 2020; 33(2):167-174 Original Article The high prevalence of insufficient knowledge about cardiac arrest can be explained by several factors. The actions of permanent education in health in these services, and even the search for qualification courses can be considered as part of the process of training these professionals in their respective studies. A study among undergraduates in health sciences showed that 99.9% of the participants did not reach the 84% minimum score recommended by the American Heart Association, characterizing insufficient knowledge about the subject of Basic Life Support. 13 During the training of nurses, the theoretical and practical contents on CA/CPR have been worked in a very limited and superficial way, and in most cases do not meet the needs of students. 16 Nursing professionals are often subjected to grueling workloads, as well as low salaries and double work hours. These facts contribute to the reduction of time dedicated to improvement and search for knowledge. Organizational aspects of the work may influence the participation of nurses in training, drawing attention to the absence of time allocated for this purpose, little financial resources, and shiftwork. 17 One study showed that only 6% of nursing undergraduate students in a pre-test achieved at least the minimum score for resuscitation. However, after the training course, the percentage of approvals increased to 72%. 18 Another study conducted among nursing undergraduate students in Brazil also presented similar results, in which approximately 20% of the students knew the correct conduct after the detection of CA. 19 This fact brings important information: even during undergraduate studies, the students have low knowledge on this topic, evidencing the fragility of their education. However, it demonstrates the effectiveness of the training program. In an international context, a recent study carried out in a tertiary hospital in Tanzania showed poor performance of health professionals in theoretical and practical tests (only 4% scored higher than 75% in the theoretical test). 20 The multiprofessional team is responsible for the first service in CA cases, hence why in many cases, training for the recognition and initial care of this situation is necessary. As a potential strategy, the deployment of Rapid Response Teams to act in emergencies and actions of permanent education can be effective. 21 A study carried out in a hospital with 750 beds in India showed the impact of training in CPR with respect to the return to spontaneous circulation and living hospital discharge among the studied patients. The study showed that return to spontaneous circulation increased from 19.7% to 30.1% after the team training, and hospital discharge alive rates rose from 27.5% up to 52.9%. 22 Poor knowledge of professionals requires constant updating of CA protocols. Although there is interest on the part of professionals to undertake improvement courses in this area, some barriers are still found, such as the lack of initiative of managers or employers in order to guarantee resources, spaces and incentive. 23 This study presents some limitations that should be considered. Among them, we highlight a convenience sample, not allowing the generalization of the results found. Selection bias may have occurred, since the participation of the professionals happened through their availability for acceptance, in addition to the TCLE signature having a certain identification, making professionals feel less comfortable to respond, leading to refusal to participate in this study. Moreover, it was not possible to evaluate the practical ability of professionals in this stage of the study. Conclusions The current prevalence of insufficient knowledge about cardiorespiratory arrest among the health professionals studied is high, a serious problem that requires urgent interventions in order to guarantee the quality of care during cardiopulmonary resuscitation. These actions should be based on realistic scenarios, involving theoretical and practical activities, using active teaching methodology in order to obtain a good result in the teaching-learning process. The periodicity of training should be short, given the deterioration of knowledge and new evidence that may arise with respect to actions related to cardiopulmonary resuscitation. These results can subsidizepermanent healtheducation teams of hospitals and non-hospital institutions, as well as technical training schools and universities, especially in nursing degrees and technical nursing courses. The creation and validation of the data collection instrument allows for its applicability in other studies, in addition to being able to be used in non-hospital units that attend severe patients with imminent cardiac arrest, and educational institutions could similarly evaluate the students’ knowledge about the subject.