Retention of CPR skill and knowledge among Nurses and Nursing Students following BLS training -an integrative literature review

Aim This review aimed to critically synthesise the evidence relating to the retention of cardiopulmonary resuscitation (CPR) skills and knowledge following Basic Life Support (BLS) training among nurses. Background Nurses’ retention of CPR skills is essential for effective patient care during cardiac arrest. Evidence indicates that skills and knowledge decline rapidly post-training, raising concerns about current training practices. Design An integrative literature review was conducted to answer the research question. Data Sources A comprehensive search was conducted using PubMed, CINAHL and MEDLINE and relevant national and international policies and guidelines related to CPR/BLS training. A five-year timeframe was selected to obtain current evidence. No geographical or methodological restrictions were applied. Only full-text, peer-reviewed articles in English were included. Review Methods Articles were screened using predetermined inclusion and exclusion criteria. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) prior to inclusion. Thematic analysis was used to identify key concepts from the findings of included studies. Results Thirteen studies met the inclusion criteria, including randomised controlled trials, observational and longitudinal designs. Three themes emerged: skill decay post-training, particularly in compression depth and ventilation accuracy; the impact of training intervals, with shorter, more frequent sessions associated with greater retention; and the effectiveness of technology-enhanced training. Tailored training and real-time feedback supported skill retention. Conclusion Traditional two-yearly BLS training may be insufficient to maintain CPR competence. Findings support shorter, spaced training intervals and personalised, technology-enhanced approaches. Further research is needed to examine real-world effects on patient outcomes and feasibility in practice.