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Background <p>In spite of focused cardiopulmonary resuscitation (CPR) training, the in-hospital cardio-pulmonary resuscitation (CPR) performance often remains suboptimal, due to technical domain barriers and non-technical skill (NTS) barriers. We aimed to determine the technical domain and NTS barriers encountered by the in-hospital interprofessional (IP) CPR resuscitation teams through a cross-sectional, quantitative, analytical survey, and to determine whether a poor NTS score alone is associated with non-adherence to high-quality CPR.</p> Methods <p>A validated questionnaire was developed comprising 17 items on technical domain barriers and 9 on the NTS barrier domain. A web-based Likert-scale questionnaire was administered to assess perception-based barriers among 400 IP team members across healthcare settings in India, focusing on technical domain barriers and NTS domain barriers. IP members with at least 1 year of work experience, hands-on CPR training, and in-hospital CPR experience were recruited.</p> Results <p>There were 32.75% doctors, 29.75% nurses, 24% respiratory therapists, 10.25% emergency technicians, and 2.25% ICU technicians. The logistic regression analysis revealed that only five items independently predicted a poor technical domain score: inability to identify cardiac rhythm, non-working defibrillator, unavailability of a supraglottic airway device, unavailability of a correct-size laryngoscope blade, and a delay in loading medications. Five NTS items independently predicted a poor NTS score: lack of clear instructions from the team leader, lack of awareness of the dynamic nature of resuscitation, lack of closed-loop communication, lack of assigned tasks completed by a team member, and lack of knowledge sharing among team members. A poor NTS score is associated with perceived non-adherence to high-quality CPR (Chi-Square test, p-value &lt; 0.001).</p> Conclusion <p>Both NTS barriers and technical domain barriers were associated with perceived non-adherence to high-quality CPR.</p> Trial registration <p>Clinical Trial Registry of India CTRI/2025/05/086727 registered on 13/05/2025.</p>

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Unravelling technical domain barriers and non-technical skill barriers among interprofessional teams during in-hospital cardiac arrest: a questionnaire-based survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月13日

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  • Prabha Prakash,
  • Kirtana Raghurama Nayak,
  • Elsa Sanatombi Devi,
  • Souvik Chaudhuri,
  • Abraham Samuel Babu,
  • Dinker Ramananda Pai,
  • Vimal Krishnan S

摘要

Background

In spite of focused cardiopulmonary resuscitation (CPR) training, the in-hospital cardio-pulmonary resuscitation (CPR) performance often remains suboptimal, due to technical domain barriers and non-technical skill (NTS) barriers. We aimed to determine the technical domain and NTS barriers encountered by the in-hospital interprofessional (IP) CPR resuscitation teams through a cross-sectional, quantitative, analytical survey, and to determine whether a poor NTS score alone is associated with non-adherence to high-quality CPR.

Methods

A validated questionnaire was developed comprising 17 items on technical domain barriers and 9 on the NTS barrier domain. A web-based Likert-scale questionnaire was administered to assess perception-based barriers among 400 IP team members across healthcare settings in India, focusing on technical domain barriers and NTS domain barriers. IP members with at least 1 year of work experience, hands-on CPR training, and in-hospital CPR experience were recruited.

Results

There were 32.75% doctors, 29.75% nurses, 24% respiratory therapists, 10.25% emergency technicians, and 2.25% ICU technicians. The logistic regression analysis revealed that only five items independently predicted a poor technical domain score: inability to identify cardiac rhythm, non-working defibrillator, unavailability of a supraglottic airway device, unavailability of a correct-size laryngoscope blade, and a delay in loading medications. Five NTS items independently predicted a poor NTS score: lack of clear instructions from the team leader, lack of awareness of the dynamic nature of resuscitation, lack of closed-loop communication, lack of assigned tasks completed by a team member, and lack of knowledge sharing among team members. A poor NTS score is associated with perceived non-adherence to high-quality CPR (Chi-Square test, p-value < 0.001).

Conclusion

Both NTS barriers and technical domain barriers were associated with perceived non-adherence to high-quality CPR.

Trial registration

Clinical Trial Registry of India CTRI/2025/05/086727 registered on 13/05/2025.