Effectiveness of Simulation Techniques on the Nursing Students Knowledge toward Cardiopulmonary Resuscitation for Adults at College of Nursing/University of Baghdad

: تسارذلا فذه نا فذهح ةاكاحًنا رٍثاح تفرعي ىنإ تسارذ  تئرناو بهقنا شاعَا ِاجح ضٌرًخنا تٍهك تبهط فراعي ىهع ٍٍغنابهن .   تيجهنملا تسارد :  تٍبٌرجح ّبش  جٌرجا إ ( ثارابخخ ق لإا مب لإا ذعب ,رابخخ رابخخ 1  لإا ذعب و ابخخ ر 2 ىهع ةاكاحًنا تٍُقح تٍناعف تفرعًن ) تئرناو بهقنا شاعَا ِاجح تبهطنا فراعي  ٍٍغنابهن  .  ٍي تسارذنا ثأذب 11 / 11 / 2112   تٌاغنو 11 / 5 / 2115  ,  عًج ىح ذقو 55  بناط ضٌرًخنا تٍهك ًف تعبارنا تهحرًنا ٍي تبناطو  تسارذنا ةادأ جَىكحو  لإ ًنارخسلاا مٍنذنا ىهع داًخعلااب ا شاعَ دا ٌىكخح .تئرناو بهقن ا ة ٍي تسارذنا 21  ةرقف  ًساسلاا ًبهقنا شاعَلاا سٍقح ثارقفنا ثابث ساٍق ىحو .وذقخًناو  = رابخخلاا ةداعإو رابخخلاا ءارجإ للاخ ٍي 1..5  .ثاَاٍبنا مٍهحخن ًنلاذخسلااو ًفصىنا ءاصحلإا ثحابنا وذخخساو  جئاتنلا :  إ فلاخخ  طسىخًنا تًٍق  ابخخلاا ٍٍب مبقنا ر  لإاو لإاو لولاا يذعبنا رابخخ ًَاثنا يذعبنا رابخخ  )ث( رابخخا واذخخساب ّباسخحا ىح  اع تٍئاصحا تنلاد دىجو ىهع جئاخُنا ثرهظا . ٌرخقًنا تظىحهي ةداٌز دىجو ىنا رٍشح تٍن  تئرناو بهقنا شاعَا ِاجح تبهطنا فراعي ًف ٍٍغنابهن .   جاتنتسلاا : تظىحهي ةداٌز دىجو تسارذنا ججخُخسا  تقذنا تٍناع ةاكاحًنا تٍُقح واذخخسا ذُع تبهطنا فراعي ًف  تئرناو بهقنا شاعَلا  ًف بٌرذح  تبهطنا .  :ثايصىتلا .تبهطنا بٌرذح ًف تقذنا تٍناع ةاكاحًنا واذخخساو رٍفىح ىهع ثحابنا ًصىٌ تسارذنا جئاخُن اقفو  Abstract Objectives: The study aims to findout the effectiveness of simulation on the students knowledge toward Cardiopulmonary resuscitation for adults


Introduction
Cardiopulmonary resuscitation (CPR) is an essential skill for all health care professionals, especially nurses.It can be a lifesaver when applied by a competent and skilled person during resuscitation (1) .There are two levels of CPR are basic and advanced cardiac life support, CPR procedure is a coordinated integration of chest compression-induced circulation, rescue breathing and airway management whereby priorities are determined by evidence from literature and practice (2) .
Chest compressions being at rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood through the heart.In addition the rescuer may provide breaths by either exhaling into their mouth or utilizing a device that pushes air into the lungs.The process of externally providing ventilation is termed artificial respiration (3) .
An administering of an electric shock to the heart, termed defibrillation, is usually needed to restore a viable or "perfusing" heart rhythm.Defibrillation is only effective for certain heart rhythms, namely ventricular fibrillation, pulseless ventricular tachycardia, asystolic and pulseless electrical activity.CPR may however induce a shockable rhythm.CPR is generally continued until the person regains return of spontaneous circulation (ROSC) or is declared dead.CPR is indicated for any person who is unresponsive with no breathing or only gasps as breathing as it is most likely that they are in cardiac arrest (4) .
In the present study, nursing students were tested and then learned by educators who are well-experienced on performing CPR.This is usually followed by increase for the resuscitation knowledge in different situations while studying in the simulation lab (5) .
Over 750,000 citizens of the US and Europe suffer sudden cardiac arrest each year, and survival remains dismal: over 75% of victims do not leave the hospital alive.Cardiac arrest, requires treatment within minutes to attain survival.Cardiopulmonary resuscitation (CPR) and electrical defibrillation remain the two crucial interventions that can be life-saving during cardiac arrest.Through CPR training offered by the Australian resuscitation Council (ARC) and other organizations, laypersons can provide treatment to cardiac arrest victims before the arrival of emergency medical personnel (6) .
Simulation, the art and science of recreating a clinical scenario in an artificial setting, has been an important aspect of nursing program curriculums for decades (7) .As an adjunct to clinical experience, simulation has allowed deliberate practice in a controlled environment.Students are able to practice a procedure prior to performance on a live patient.The value of this is unquestionable.Recently, however, high-fidelity simulation, with the increased level of sophistication and realism it brings to the laboratory setting, has elicited the possibility of simulation being used as a substitute for actual clinical experience (8) .

Objectives of the study
The study aims to findout the effectiveness of simulation on the students knowledge toward Cardiopulmonary resuscitation .

Sample of the study:
A non-probability (purposive) sample of 75 student at 4th years level /morning studying.Study Instrument: Basic and advance life support were measured by using twenty question depending on Australian cardiopulmonary resuscitation guide .Reliability of the Questionnaire: Determination the reliability of the items scale was based upon the test retest of the questionnaire = 0.85 Statistical analysis: The researcher used the appropriate statistical methods in the data analysis which included descriptive data analysis and inferential data analysis.

Discussion
The results reveal that a highly statistical significant association were found among pretest, post test1 and post test 2. The marked increase in the mean of students knowledge suggest that the Simulation Techniques for undergraduate nursing education are the best to enhance teaching and learning quality by creating a collaborative community for knowledge.
This results comes along with the study done by National Athletic Trainers Association "The Effect of High-Fidelity Cardiopulmonary Resuscitation (CPR) Simulation on Athletic Training Student Knowledge, Confidence, Emotions, and Experiences" .The study was conducted in the University's high-fidelity simulation center, A mixed methods study design was employed with pre-and post intervention evaluations of students'cardiopulmonary resuscitation (CPR) knowledge, confidence, emotions.a significant increase through a paired sample t test (t = 5.640, P, .001)demonstrate a significant difference in athletic training student knowledge toward CPR (9) . in addition to that, another study done by Wiker.k.This study done at Brigham Young Universit; explored the benefits and limitations of using an human patient simulator (HPS) as a patient substitute for one day of actual clinical experience for nursing students.Learning outcomes included increased student knowledge, ability, and confidence in cardiopulmonary resuscitation (10) .

Conclusions
the study conclude that the Simulation Techniques are a highly effective to increase the students knowledge toward cardiopulmonary resuscitation.

Recommendation
According to the findings of the study the researcher recommend to Prepare a special high-fidelity simulation center in the each nursing college.
Study: a quasi-experimental study with pre test , post test 1 and post test 2 were conducted to identify the effectiveness of simulation on the students knowledge toward Cardiopulmonary resuscitation.The study starting from November 10th 2014 to the May 10th 2015.Setting of the Study: College of Nursing/ University of Baghdad.

Table 1 :
Analysis of variance among per test, post test 1 and post test 2 related to cardiopulmonary resuscitation