Evaluation of the effectiveness of first aid training in shopping center employees Текст научной статьи по специальности «Фундаментальная медицина»

A SMI Original article

"V* SEMEY MEDICAL UNIVERSITY

Received: 10 August 2018 / Accepted: 17 November 2018 / Published online: 28 February 2019 UDC: 614.88+377.354

EVALUATION OF THE EFFECTIVENESS OF FIRST AID TRAINING IN SHOPPING CENTER EMPLOYEES

Burak Celik 1, Derya Ozturk 1, Nikola Yapar 1, Ertugrul Altinbilek 1, ibrahim Ikizceli 1, Nazli Celik 1, Murat Muratoglu 2, Gulsum Kavalci 3, Cemil Kavalci 2

1

§i§li Hamidiye Etfal Training and Research Hospital, Emergency Department, Istanbul, Turkey;

2 Baskent University Faculty of Medicine Emergency Department, Ankara, Turkey.

3 Yenimahalle Training and Research Hospital, Deparment of Anestesia, Ankara, Turkey.

Abstract

Introduction: Cardiopulmonary arrest is on of the most important causes requiring first aid in big metropolis. Cardiac arrest may be often seen in airports, shopping centers (SC), prisons, sports facilities, industrial zones, public transport stations and nursing homes. In this study, we aimed to evaluate effectiveness of training by measuring knowledge level of SC employees before and after first aid training, and to create awareness for the presence and use of automatic external defibrillator.

Material & Methods: Employees of a shopping center were trained for first aid on voluntary basis in Sisli Hamidiye Etfal Training & Research Hospital, Emergency Medicine Clinic between 01.01.2015 and 31.06.2015. A total of 332 volunteer shopping center employees were included in the study. Pretest and posttest questions and first aid training were organized based on AHA 2010 guidelines.

Results: The mean age of participants was 33.8±8.0 years and 233 (70.2%) of them were male. Of participants 74.4% were working for less than one year, 83.1% were cleaning staff and security guard, and 42.8% were high school graduated. It was found that post-training correct answer rate was found to be statistically significantly increased in all test questions. There was a weak negative correlation before the training, and a strong negative correlation after the training between total test score and age. In addition, educational status of the participants was correlated with both pre- and post-training total test score with both pre- and post-training total scores were increased with educational level.

Conclusion: First aid training is important in crowded places such as shopping centers where cardiac arrest is likely to be encountered. Therefore, training employees for first aid could provide correct emergency first response. Keywords: first aid training, shopping center, cardiac arrest, training.

Резюме

ОЦЕНКА ЭФФЕКТИВНОСТИ ОБУЧЕНИЯ СОТРУДНИКОВ ТОРГОВОГО ЦЕНТРА ПО ОКАЗАНИЮ ПЕРВОЙ МЕДИЦИНСКОЙ ПОМОЩИ

Burak Celik 1, Derya Ozturk 1, Nikola Yapar 1, Ertugrul Altinbilek 1, ibrahim Ikizceli 1, Nazli Celik 1, Murat Muratoglu 2, Gulsum Kavalci 3, Cemil Kavalci 2

1 Учебно-исследовательский госпиталь имени Сисли Хамидие Этфал, Отделение неотложной помощи, г. Стамбул, Турция;

2 Башкент университет, Медицинский факультет, Отделение неотложной помощи, г. Анкара, Турция;

3 Учебно-исследовательский госпиталь Енимахалле, Отделение анестезии, Анкара, Турция.

Введение: Остановка сердечной деятельности является одной из наиболее важных причин, требующих неотложной помощи в больших городах. Остановка сердечной деятельности может произойти у посетителей торговых центров, в аэропорту, местах заключения, спортивных объектах, промышленных зонах, станциях общественного транспорта и домах ухода. Целью представленного исследования явилась оценка эффективности обучения сотрудников торгового центра путем измерения уровня знаний до- и после первого тренинга по оказанию неотложной медицинской помощи и повышение осведомленности о наличии и использовании автоматического внешнего дефибриллятора.

Материалы и методы: В период с 01.01.2015 по 31.06.2015 сотрудники торгового центра на добровольной основе проходили обучение для оказания первой медицинской помощи в Учебно-исследовательском госпитале, Больнице скорой медицинской помощи имени Сисли Хамидие Етфаль. Всего в исследование было включено 332 сотрудника волонтерского торгового центра. Предтестовые и посттестовые вопросы, а также обучение по оказанию

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Наука и Здравоохранение, 2019,1 (Т.21) Оригинальные исследования

--" SEMEY MbDICAL UNIVERSITY

первой помощи были организованы на основе рекомендаций AHA 2010 г.

Результаты: Средний возраст участников составил 33,8±8,0 лет, 233 (70,2%) из них оказались мужчинами. Стаж работы у 74,4% участников составил не менее одного года, 83,1% относились к сотрудникам, занимающимся уборкой помещений и охранникам, 42,8% имели высшее образование. Частота правильных ответов после обучения статистически значимо возрастала во всех тестовых вопросах. Установлена слабая отрицательная корреляция до обучения и сильная отрицательная корреляция после обучения между общим баллом теста и возрастом сотрудников. Кроме того, образовательный статус участников коррелировал с итоговыми результатами как до-, так и после обучения, а общие баллы как до, так и после тренировки увеличивались с уровнем образования.

Заключение: Обучение первой медицинской помощи является очень важной мерой в общественных местах, таких как торговые центры, где может возникнуть остановка сердца у посетителей. Таким образом, обучение сотрудников по оказанию первой помощи может обеспечить правильное реагирование в неотложных ситуациях.

Ключевые слова: обучение первой медицинской помощи, торговый центр, остановка сердечной деятельности, тренинг.

Туйшдеме

Б1Р1НШ1 МЕДИЦИНАЛЫК К0МЕК К0РСЕТУ БОЙЫНША САУДА ОРТАЛЫГЫ ККЫЗМЕТКЕРЛЕР1Н ОКЫТУДЫН ТИ1МД1Л1Г1Н БАГАЛАУ

Burak Celik 1, Derya Ozturk 1, Nikola Yapar 1, Ertugrul Altinbilek 1, ibrahim Ikizceli 1, Nazli Celik 1, Murat Muratoglu 2, Gulsum Kavalci 3, Cemil Kavalci 2

1 Сисли Хамидие Этфал Оку - гылыми госпиталi, Шугыл кемек бвлiмшесi, Стамбул к., Туркия;

2 Башкент университет, Медициналык факультет, Шугыл кемек бвлiмшесi, Анкара к., Туркия;

3 Енимахалле Оку - гылыми госпитале Анестезия бвлiмшесi, Анкара к., Туркия.

Kipicne: ЖYрек ^ызметiнi4 токтауы Yлкен калалардагы шугыл квмектi талап ететiн еч ма^ызды себептердщ бiрi болып табылады. ЖYрек ^ызметiнi4 токтауы сауда орталыктары келуштермен, эуе жайда, бас бостандыгынан айыру орындары, спорттык нысандар, когамдык квлктер стансаларында жэне куту Yйлерiнде болуы мYмкiн. Шугыл медициналык квмек кврсету бойынша бiрiншi тренингке дейiнгi жэне содан кейiнгi бiлiм дечгейiн влшеу жолымен сауда ортылыгы кызметкерлер^ окытудьщ жэне автоматты сырткы дефибрилляторды пайдалану тшмдтИн багалау усынылган зерттеу максаты болды.

Материалдар мен эдiстер: 01.01.2015 - 31.06.2015 мерзiмде сауда орталыгы кызметкерлерi ерiктi негiзде бiрiншi медициналык квмек кврсету Yшiн Оку - зерттеу госпиталында, Сисли Хамидие Етфаль атындагы жедел медициналык квмек Ауруханасында окытудан вттi. Зерттеуге сауда орталыгы ерiктiлерiнен барлыгы 332 кызметкер енпзтдк Тесталды жэне тесттен кейiнгi сурактар, сондай-ак бiрiншi квмек кврсету бойынша окыту АНА 2010ж нускаулары непанде уйымдастырылды.

Нэтижелерi: ^атысушылардыщ орташа жасы 33,8±8,0 жасты курады, осыдан 233 (70,2%) ер адамдар болды. ^атысушылардыщ 74,4% жумыс втiлi бiр жылдан кем емес, 83,1% бвлмелердi жинаумен айналысатын кызметкерлер мен кYзетшiлер, 42,8% жогары бiлiм бар. Окытудан кейЫ дурыс жауаптар жиiлiгi барлык тесттк сурактарда статистикалык барынша встi. Окуга дейiнгi болымсыз терiс корреляция жэне окудан кейiнгi кYштi терiс корпреляция тестщ жалпы баллымен жэне кызметкерлер жасы арасында байкалды. Содан баска, катысушылардыщ бiлiм м8ртебесi окуга дейшп жэне окудан кейiнгi корытынды нэтижелермен корреляцияланды, ал жалпы баллдар жаттыгуга дейiн жэне жаттыгудан кейiн б^м де^гешмен бiрге артты.

Корытынды: Бiрiншi медициналык квмек кврсету когамдык орындарда, сол сиякты келушiлер жYреriнщ токтауы болуы мYмкiн сауда орталыктарындагы вте ма^ызды шара болып табылады. Сонымен, бiрiншi квмек кврсету бойынша кызметкерлердi окыту шугыл жавдайларда дурыс шешiм кабылдауды камтамасыз етуi мYмкiн.

TYÜiHdi свздер: Бiрiншi медициналык квмек кврсетуге окыту, сауда орталыы, жYрек кызметнщ токтауы, тренинг, окыту.

Библиографическая ссылка:

Burak Celik, Derya Ozturk, Nikola Yapar, Ertugrul Altinbilek, ibrahim Ikizceli, Nazli Celik, Murat Muratoglu, Gulsum Kavalci, Cemil Kavalci Оценка эффективности обучения сотрудников торгового центра по оказанию первой медицинской помощи // Наука и Здравоохранение. 2019. 1 (Т.21). С. 58-62.

Celik Burak, Derya Ozturk, Nikola Yapar, Ertugrul Altinbilek, ibrahim Ikizceli, Nazli Celik, Murat Muratoglu, Gulsum Kavalci, Cemil Kavalci Evaluation of the effectiveness of first aid training in shopping center employees. Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 1, pp. 58-62.

Burak Celik, Derya Ozturk, Nikola Yapar, Ertugrul Altinbilek, ibrahim Ikizceli, Nazli Celik, Murat Muratoglu, Gulsum Kavalci, Cemil Kavalci Бiрiншi медициналык квмек кврсету бойынша сауда орталыгы кызметкерлер^ окытудыщ тшмдтИн багалау // Гылым жэне Денсаулык сактау. 2019. 1 (Т.21). Б. 58-62.

A SMI Original article_

IM1 SEMEY MEDICAL UNIVERSITY

Introduction

First aid is defined as non-medication applications with the existing tools and equipments without seeking medical equipment in order to save life or to prevent worsening of the conditions until healthcare personnel come to the scene in a case of accidents of life threatening conditions. Many people lose their lives or have to live with disability because of the troubles in first aid services or insufficient public first aid awareness in our country [1].

Cardiopulmonary arrest is on of the most important causes requiring first aid in big metropolis. Cardiac arrest may be often seen in airports, shopping centers (SC), prisons, sports facilities, industrial zones, public transport stations and nursing homes [4, 5, 11].

Sudden cardiac arrest (SCA) is among the leading causes of death in Europe. According to the data of last 20 years, the incidence of SCA in 55 to 113 / 100.000 annually (350,000-700,000 persons a year). Again according to these data, when rhythm records were taken with automatic external defibrillator immediately after SCA, VF rhythm ratio raises up to 76%, but since the first ECG record is taken by the emergency staff in the emergency room, asystole heart rhythm is more commonly seen, and success of resuscitation is lower in these patients [13].

Shopping centers have becomes leisure time places of urban life for many different people groups [9, 16]. Although some shopping centers have healthcare units to meet first aid requirement, and although there are healthcare units in shopping centers established in a wide area, arrival of first aid to people who develop sudden health problem may take time and first aid may be needed in this time interval. Regression of skills after personnel training is a commonly encountered problem where needed, because CPR may be forgotten if is not applied over time. Repeat training at least once a year is important, but it has been reported that, only 20% of the trained persons in the USA receive yearly regular training [10].

In this study, we aimed to evaluate effectiveness of training by measuring knowledge level of SC employees before and after first aid training, and to create awareness for the presence and use of automatic external defibrillator.

Material and Methods

The study was conducted in Sisli Hamidiye Etfal Training and Research Hospital, Emergency Medicine after receiving the approval from the local ethics committee (09/12/2014 - 799). First aid training was given to employees of shopping centers that accepted to participate in the first aid training program and pre- and post-test application on a voluntary basis. A total of 332 volunteer shopping center employees were included in the study. Pretest and posttest questions and first aid training were organized based on AHA 2010 guidelines. Groups of 30 persons were created among employees of the shopping centers that accepted to participate in the first aid training program and pre- and post-test application. Pre-test was applied to the shopping center employees with 25 questions for 25 minutes. Demographic data

including age, gender, duration of working, position, and educational status were recorded during the pre-test. One hour of theoric and one hour of practice first aid training were given by an emergency medicine specialist. Within the scope of the training; basic life support, automatic external defibrillator, basic first sid knowledge, and basic medical knowledge were presented. After the training, again a post-test of 25 question was applied for 25 minutes. Our test questions consisted of 13 practice and 12 theoric questions. The test included nine questions about basic life support, 12 about non-BLS first aid, three about basic knowledge and two about automatic external defibrillator. Of the questions regarding basic life support; eight were related to circulation, five related to airway, five related to respiration and two related to after basic life support. Non-BSL questions consisted of six questions about general information, two about bleeding, four about trauma, and two about burn.

Statistical analysis

Data were analyzed with SPSS for Windows version 22.0 software. Descriptive statistics of continuous variables were expressed as mean ± standard deviation, while categorical variables were given as number and percentage. Parametric tests were used in the analysis of normally distributed data, and non-parametric tests in non-normally distributed data. Mann Whitney U test was used for the comparison of two groups, and Kruskal Wallis test for comparisons between more than two groups. Correlations of the continuous variables was evaluated with Spearman's correlation test with a correlation coefficient between 0-0.3 was considered as a weak, between 0.3-0.7 as a moderate, and >0.7 as a strong correlation. p<0.05 values were considered statistically significant.

Results

Mean age of the participants was 33.8 ± 8.0 years and 233 (70.2%) of them were male. Of participants 74.4% were working for less than one year, 83.1% were cleaning staff and security guard, and 42.8% were high school graduated (Table 1).

It was found that post-training correct answer rate was found to be statistically significantly increased in all test questions (Table 2).

There was a weak negative correlation before the training, and a strong negative correlation after the training between total test score and age (pre-training: p=0.006, r=-151; post-training: p<0.001, r=-307).

Total test scores were increased in all participants after the training. Pre- and post-training total test scores did not differ according to duration of working (Table 1). Both pre and posttraining total test scores were correlated with position of the participants with the highest mean score was found in technical personnel and the lowest mean score in cleaning staff (p<0.001). In addition, educational status of the participants was correlated with both pre-and post-training total test score with both pre- and posttraining total scores were increased with educational level (p<0.001).

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IW SEMEY MEDICAL UNIVERSITY

Table 1. Relationship of pre- and post-training test scores with gender, duration of work, position and educational status of personnel.

Total test Scores

Pre-training Post-training

n(%) mean±SD mean±SD p

Gender

Female 233 (70.2%) 11.3±4.1 18.2±3.5 <0.001

Male 99 (29.8%) 10.9±4.3 17.5±4.1 <0.001

Duration of working

0-6 months 122 (36.7%) 11.3±4.2 17.7±3.9 <0.001

7-12 months 125 (37.7%) 11.3±4.0 18.1±3.8 <0.001

13-24 months 32 (9.6%) 9.0±4.6 16.4±4.7 <0.001

>25 months 53 (16. 0%) 11.1±4.4 17.8±3.8 <0.001

Position

Cleaning staff 120 (36.1%) 9.0±3.7 15.0±4.0 <0.001

Security guard 150 (45.2%) 12.3±4.0 19.3±2.9 <0.001

Sales staff 26 (7.8%) 10.8±3.6 17.8±3.2 <0.001

Technical staff 22 (6.6%) 13.0±4.1 20.4±2.2 <0.001

Manager 14 (4.2%) 12.4±4.9 20.4±1.9 <0.001

Educational status

Primary school 89 (26. %8) 8.7±3.5 15.0±3.9 <0.001

Middle School 69 (20.8%) 10.7±4.1 17.0±3.8 <0.001

High school 142 (42.8%) 12.1±4.1 19.3±3.1 <0.001

University 32 (9.6%) 13.5±3.8 20.2±2.2 <0.001

Table 2. Evaluation of pre- and post-training test scores.

Total test score

Practice

Theoric

Basic life support Non-BLS first aid Basic knowledge Automatic external

defibrillator Circulation Airway Respiration After BLS

General Information

Bleeding

Trauma

Burn

Discussion

In our study, rate of male participants was 70.2%. Higher number of male participants may be explained from the professions such as security and technical service are more commonly preferred by men in our country. Pre- and post-training total test scores were similar between female and male participants, and the total scores were increased after the training in both sexes. In a similar study by Ozkan H with policemen, no significant difference was found between the two sexes [12]. In similar studies with healthcare personnel, it was found that gender did not affect knowledge level about basic life support [6, 8].

In our study, pre- and post-training total test scores

1.001 1.001 1.001 1.001 .001 .001 .001

.001 .001 .001 .001 .001 .001 001 .001

were decreased with age, and this was thought to be explained by the decreased cognitive functions by ageing. In the study by Ozkan H, when knowledge level of policemen was evaluated according to age groups, the increase in post-training scores compared to pre-training scores in > 40 years age group was statistically significantly higher than the other age groups and this age-proportional increase was attributed to that high professional experience of policemen positively affected firt aid training [12]. In a study by Aygin A with nurses, increases in correct rates proportional duration of working were statistically significant, and it was reported that this might be caused by increasing experience with age [3]. On the other hand, duration of working was not correlated

Pre-training Post-training

Median Median

mean±SD (min-max) mean±SD (min-max) p

11.0±4.2 11 (0-25) 17.7±3.9 19 (3-25) <0

5.7±2.7 6 (0-13) 9.0±2.3 10 (0-13) <0

5.4±2.0 5 (0,12) 8.6±2.2 9 (0-12) <0

3.0±1.8 3 (0-9) 5.9±1.9 6 (0-9) <0

6.6±2.7 7 (0-12) 9.2±2.2 10 (0-12) <0

1.4±0.8 1 (0-3) 2.3±0.8 2 (0-3) <0

0.5±0.7 0 (0-2) 1.3±0.7 1 (0-2) <0

2.2±1.5 2 (0-8) 5.0±1.7 5 (0-8) <0

2.0±1.3 2 (0-5) 3.2±1.3 3 (0-5) <0

1.5±1.1 1 (0-5) 2.8±1.2 3 (0-5) <0

0.9±0.7 1 (0-2) 1.2±0.7 1 (0-2) <0

3.3±1.3 3 (0-6) 4.4±1.3 5 (0-7) <0

1.3±0.7 1 (0-2) 1.7±0.5 2 (0-2) <0

2.1±1.2 2 (0-4) 2.8±1.0 3 (0-5) <0

1.2±0.8 1 (0-2) 1.8±0.5 2 (0-2) <0

jy SMI S Original article

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with pre- and post-training total scores. Similar to our study, Kimaz S et al. reported that duration of working had no effect on knowledge level about first aid, but the knowledge level was increased after the training [8].

In our study, besides total test scores knowledge levels about practice, theoric, basic life support, first aid, basic knowledge, automatic external defibrillator, circulation, airway, respiration, bleeding, trauma and burn were significantly increased after the training compared to before the training. All similar studies have reported increased knowledge levels after training [12, 15, 2, 7].

In our study, both pre- and post-training total test scores were increased by educational level. Similarly, in a study by Saruhan et al knowledge level about first aid was increased as educational level increased [14]. Educational level is an effective factor in first aid knowledge. Results of these studies were consistent with our results.

In conclusion, emergency, life threatening conditions and cardiac arrest may be seen any moment in crowded places such as shopping centers. Training shopping center employees on this subject can increase chance of survival with life saving intervention when first aid is needed, and thus, patients can be protected against permanent damage.

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Corresponding Author:

Cemil Kavalci - Prof. Dr. Baskent University Faculty of Medicine Emergency Department, Ankara, Turkey e-mail: [email protected] рhоne: +903122036868