Cardiopulmonary resuscitation (CPR) is a life-saving emergency procedure, and nurses are the most frequent first responders to in-hospital cardiac arrest. Yet their CPR competence, and the challenges they face in low-resource settings, remain understudied. This study assessed CPR knowledge, practice challenges, and the influence of clinical experience and equipment adequacy among nurses in tertiary health institutions in Ekiti State, Nigeria. A descriptive cross-sectional survey was conducted among 291 registered nurses randomly selected from three tertiary hospitals: Afe Babalola Multisystem Hospital (AMSH), Ekiti State University Teaching Hospital (EKSUTH), and Federal Teaching Hospital Ido-Ekiti (FETHI). Data were collected using a validated structured questionnaire (Cronbach’s α = 0.82) and a 20-item American Heart Association (AHA)-based skills checklist. Descriptive statistics, chi-square tests, and binary logistic regression were used for analysis (SPSS v27). The majority (67.4%, 196/291) had good CPR knowledge (>75% correct). Knowledge gaps were noted for compression rate (67.7% correct), compression-to-ventilation ratio (70.8%), and maximum pause for endotracheal tube placement (77.0%). Major practice challenges included lack of retraining (86.3%), lack of proper training (84.9%), lack of continuous practice (84.5%), high workload (80.1%), and lack of equipment (79.0%). Clinical experience was significantly associated with knowledge (χ² = 6.442, p = 0.040); nurses with ≥21 years had the highest good knowledge (81.0%). After adjustment, ≥21 years of experience gave 3.21 times higher odds of good knowledge (AOR = 3.21, 95% CI: 1.21–8.52, p = 0.019). Equipment adequacy was strongly associated with skills performance (χ² = 12.847, p < 0.001; AOR = 2.58, 95% CI: 1.45–4.59, p = 0.001). While most nurses have acceptable theoretical knowledge, systemic challenges, lack of retraining, equipment shortages, and heavy workloads severely undermine skills performance. Mandatory biannual refresher training, equipment procurement and maintenance protocols, and supportive institutional policies are urgently needed.
Keywords: CPR knowledge, Ekiti State, Nigeria, Nurses, cardiopulmonary resuscitation, equipment adequacy, practice challenges
