Cardiopulmonary Resuscitation Skills Competency among Nurses and Adequacy of Resuscitation Equipment in Tertiary Health Institutions: A Systematic Review (Published)
Cardiopulmonary resuscitation (CPR) is a critical life-saving intervention for cardiac arrest. Nurses are often the first responders to in-hospital cardiac arrest, yet their skills competency and the availability of resuscitation equipment remain major concerns, particularly in low- and middle-income countries such as Nigeria. The study evaluated evidence on CPR skills competency among nurses and the adequacy of resuscitation equipment in tertiary health institutions, with a focus on Nigeria and comparable settings, and to identify gaps relevant to Ekiti State. PubMed, Scopus, Web of Science, CINAHL, and African Journals Online were searched from January 1, 2015, to March 31, 2026, following PRISMA 2020 guidelines. Quality was assessed using the Joanna Briggs Institute (JBI) checklist and the Newcastle–Ottawa Scale. A narrative synthesis was conducted due to heterogeneity. Fifteen studies met the inclusion criteria (12 cross-sectional, 2 cohort, and 1 mixed-method audit). CPR skills competency among nurses was generally low to moderate. Estimates indicated that only 28–45% of nurses performed correct compression depth (≥5 cm), 35–50% achieved a correct compression rate (100–120/min), and 30–55% demonstrated proper bag-valve-mask ventilation technique. Competency deteriorated significantly within 3–6 months of training. Simulation-based training improved skills by 30–50% post-intervention, but decay was rapid. Equipment audits revealed that defibrillators were available in 67–100% of intensive care units but only 20–45% of general wards. Bag-valve-masks were available in 80–95% of ICUs versus 40–60% of wards. Only 20% of Nigerian referral hospitals had a cardiac arrest response team, 21% documented CPR events, and 21% conducted event reviews. Equipment non-functionality ranged from 15% to 40%. Common barriers included absence/unpreparedness of equipment (mean barrier score 2.53/3) and incorrect device use (2.47/3). No studies from Ekiti State were identified, and only one study examined the relationship between equipment availability and nurses’ CPR performance. Substantial gaps exist in nurses’ CPR skills competency and resuscitation equipment availability/adequacy in Nigerian tertiary institutions and similar settings. Competency is low and decays rapidly; equipment is often unavailable outside ICUs. No evidence from Ekiti State was found, creating an urgent need for baseline assessment.
Keywords: CPR competency, Nigeria, Nurses, Systematic Review, cardiopulmonary resuscitation, resuscitation equipment, tertiary hospital