The participants were 66 nurses and one of them was male and the rest were female. Mean ± SD of participants’ age was 30.27±6.71 (i.e., ranging in range from 23 to 48 years old) and nurses’ experience was 6.79±6.36 (1-27) years. The educational level of most participants was nursery bachelor (92.4%), while the rest (6.1%) were nursery associate, or (1.5%) nursery Msc. Most (31.8%) worked in ED, and 19.7% worked in CCU, while 16.7% worked in men and 16.7% in women’s internal wards, and 15.2% in ICU.

Mean ± SD score of the nurses’ was 35.24±2.45 at baseline and increased to 38.07±1.58 after the educational intervention (p<0.001).

The classification of the participants’ age showed that the higher scores before and after intervention were in the experienced group (i.e., <30 and >30 showed) as (p<0.001) (Table 1). Moreover, there was a significant negative relationship between the scores and age (r=-0.33, p-value=0.006). Classification of the nurses’ experience showed a significant difference in mean scores of nurses with various job experiences. This revealed that the scores increased by increasing the years of experiences (p<0.001) (Table 1). There was also a significant difference in mean scores of nurses who worked in various wards and the nurses who worked in men’s internal ward showed the highest increase in mean score (p<0.001) (Table 1). But the mean scores of nurses did not differ significantly based on their educational level (p=0.13), as shown in Table 1.

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Table 1: Mean scores of the participants based on the working unit/ward

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Table 2: Mean and standard deviation of participants’ scores based on their demographic characteristics

DISCUSSION

The present study determined that the nurses of Taleghani hospital had a satisfactory CPR clinical function which increased after receiving educational training of CPR guidelines, with higher mean scores in experienced nurses with higher job experiences.

CPR is an important measure to improve the mortality and morbidity of patients after cardiopulmonary arrest. Thus, it is essential to pay more attention to success rate of CPR (15). In Iran, a recent study reported that 95.2% of CPR attempts were unsuccessful and less than 5% survived to receive hospital discharge (16). Nurses play a significant role in patients’ survival, as they are the first who come to the patients’ aid, so Success rate of CPR is significantly associated with the nurses’ skills (17, 18).

Studies have indicated that nurses’ knowledge is significantly associated with their CPR performance (19), and have, therefore, suggested that periodical education of nurses on CPR can increase nurses’ knowledge and skill (20). Thus, many countries perform routine educational programs for nurses, and they have reported that it increases nurses’ knowledge and skill, but it may not decrease their anxiety (8).

The results of this study agrees with an Iranian study, Saghafinia and colleagues (2015) who designed a 20-item questionnaire and reported that 54.75% of nurses responded correctly to the knowledge question; however, the psychomotor skills were very low and that increased after training (21), which is consistent with the results of the present study, considering the association of knowledge and clinical function (22). They also showed that the nurses’ knowledge that increased to 80.6% after education, decreased to 64.3% after two years, which indicates the necessity of periodic education of nurses about CPR (21). Another study that examined CPR performance of nurses in Fasa showed that among 140 Iranian nurses, a 4-hour course could significantly increase their CPR performance (23). This is consistent with the results of the present study. Studies in other countries have also confirmed that nurses’ knowledge significantly increase after education(24,25). Källestedt confirmed that standardized cardiovascular education could increase the knowledge of nurses that was consistent with our study outcomes. The findings of the present study were confirmed by his colleagues (24). In addition, Moule reported that nurses’ clinical practice increased after training for cardiopulmonary resuscitation guidelines (25). Moreover, the results of studies in other countries are consistent with the results of the present study and emphasize the necessity of educational programs for nurses involved in CPR.

Another finding of the present study was statistically significant higher scores in nurses with higher experience, which is in line with previous research, indicating the association between experience of the CPR team leader and success rate (26). Moreover, studies have indicated that even experienced nurses require training on CPR (27). The present study also indicated that after invention, the score of nurses with the highest experience reached nearly the maximum score, which showed the efficacy of training in experienced nurses. Hosseini et al showed that the trainer’s skill and experience play a significant role in success of the training (28), which is consistent with the results of the present study.

Some studies have also focused on the type of education that can have the highest efficacy which suggests using human models, educational films, and reference books as the best method with the highest efficacy (29). The significant increase in nurses’ skills in the present study showed the efficiency of the training sessions that were performed by skilled educational supervisors with high experience. All of these studies are consistent with the current study, suggesting that a continuing education course can significantly increase the clinical performance of nurses’ cardiopulmonary resuscitation. So, this is a matter of great importance and must be included in Clinical decision-making.

Beside the strengths of the current study, it also had some limitations, such as limited sample size and taking place in one hospital. Moreover, the nurses’ were only evaluated for a short period after educational training. These limitations result in non-generalizability of the results. Thus, it is suggested that future multi-centric studies evaluate the nurses’ after educational programs in longer follow-ups.

In conclusion, nurses’ knowledge significantly increased after an 8-hour educational session by an educational supervisor in CPR which indicated the efficacy of CPR training for nurses who can perform effectively to increase the success rate of CPR in Iran.

Acknowledgment
All financial resources of this research provided by Student Research Committee, Abadan School of Medical Sciences, Abadan, Iran. Verification code is 95st-0095 and this research is approve by Ethics Committee (code: IR.ABADANUMS.REC.1395.138).