A CROSS-SECTIONAL STUDY OF ASSESSING KNOWLEDGE, ATTITUDE, AND PRACTICE OF COVID-19 RESUSCITATION AMONG HEALTHCARE WORKERS IN THE EMERGENCY DEPARTMENT, UNIVERSITY MALAYA MEDICAL CENTRE, MALAYSIA

Abstract

Introduction: The COVID-19 pandemic is an international public health emergency. As hospitals receive more severe forms of COVID-19 that necessitate resuscitation, emergency healthcare workers (HCW) must follow interim COVID-19 resuscitation guidelines.

Objectives: Our aim is to evaluate the levels of knowledge, attitude, and practice among emergency HCW of the COVID-19 resuscitation protocol by the European Resuscitation Council (ERC).

Methods: A cross-sectional study using a validated questionnaire was conducted among HCW in the emergency department of University Malaya Medical Centre, Malaysia from April to June 2021. 

Results:  A total of 159 respondents were participated.  68% (n = 108) of respondents had adequate knowledge regarding COVID-19 resuscitation. 73% (n = 117) were pessimistic about the COVID-19 prognosis. 73% (n = 117) of respondents thought an arrested COVID-19 patient may benefit from cardiopulmonary resuscitation (CPR) and 94% (n = 150) were willing to administer CPR provided airborne-precaution personal protective equipment was available. 90% (n = 143) of respondents reported adherence to resuscitation guidelines. There were significant differences in the mean knowledge scores between designation and education levels. Overall, the respondents’ level of practice was insufficient (27% n = 43), with a mean score of 53.7% (SD = 14.7). There was a lack of practice in the resuscitation of the intubated and patients who were being prone. There was insufficient practice about defibrillation, use of supraglottic devices, and intubation barriers.  There was a correlation between adequate knowledge and good practice. 

Discussion: Our study demonstrated a correlation between adequate knowledge and good practice, but found no correlations between knowledge and attitude or attitude and practice. Our participants were in a highly stressful situation due to the rapid surge of COVID-19 cases. Psychological stress and fatigue among HCW cultivates negative perception of patient outcomes, inadvertently causing poor quality of care and pose as a risk to patient safety. Although respondents were confident and willing to resuscitate COVID-19 patients, they were pessimistic about patients’ prognosis. 

Conclusion: Emergency HCW had adequate knowledge, positive attitudes towards performing CPR, and adherence to resuscitation protocols. However, they lack the practice of resuscitating the COVID-19 patients and were pessimistic about the prognosis of these patients.