Cardiovascular

Knowledge-based Basic Life Support competency and associated factors among healthcare professionals across different hospital levels: a multicenter cross-sectional study.

TL;DR

Knowledge-based BLS competency among surveyed healthcare professionals remained suboptimal, with only 40.26% achieving high competency, and particularly notable knowledge gaps in defibrillation-related topics, with professional role, hospital level, and educational background identified as associated factors.

Key Findings

Only 40.26% of surveyed healthcare professionals met the criterion for high knowledge-based BLS competency.

  • High knowledge-based BLS competency was defined as a total BLS knowledge score of ≥80 points.
  • The survey included 2,017 healthcare professionals across tertiary, secondary, and primary hospitals in Chengdu, Sichuan Province.
  • Participants included physicians, nurses, technicians, and other clinical staff.
  • Data were collected from March 2025 to March 2026 using an electronic questionnaire.
  • The questionnaire demonstrated acceptable internal consistency with a Cronbach's alpha of 0.701.

Physicians had significantly higher odds of achieving high knowledge-based BLS competency compared to technicians and other clinical staff.

  • In the multivariable logistic regression model, physicians had an OR of 3.01 (95% CI: 1.58–5.74) compared to technicians and other clinical staff.
  • Nurses also had significantly higher odds than technicians and other clinical staff (OR = 2.46, 95% CI: 1.31–4.63).
  • Professional role was significantly associated with high knowledge-based BLS competency in both unadjusted and adjusted analyses.
  • These associations remained significant after adjusting for other variables in the multivariable logistic regression model.

Healthcare professionals working in tertiary hospitals had significantly higher odds of achieving high knowledge-based BLS competency than those in primary hospitals.

  • The adjusted OR for tertiary hospital HCPs versus primary hospital HCPs was 1.48 (95% CI: 1.09–2.00).
  • Hospital level was significantly associated with high knowledge-based BLS competency in unadjusted analyses.
  • The association between hospital level and BLS competency remained significant in the multivariable regression model.
  • The study included hospitals from tertiary, secondary, and primary levels in urban Chengdu.

Defibrillation-related knowledge had the lowest domain-specific accuracy among all BLS knowledge domains.

  • Item-level accuracy and domain-specific knowledge scores were calculated across BLS knowledge domains.
  • Defibrillation-related knowledge had an accuracy of 59.06%.
  • Core CPR knowledge had the highest domain-specific accuracy at 87.43%.
  • These domain-specific findings indicate particularly notable knowledge gaps in defibrillation-related topics.

Educational level was significantly associated with high knowledge-based BLS competency in unadjusted analyses.

  • Educational level was identified as a significant factor in the unadjusted (chi-square) analyses.
  • Professional role, hospital level, and educational level were all significantly associated with high knowledge-based BLS competency in unadjusted analyses.
  • Educational background was included among the factors identified in the multivariable regression model as associated with BLS competency.
  • Specific adjusted ORs for educational level categories were not reported in the abstract.

CPR training history was assessed as a potential factor associated with BLS competency alongside demographic and professional characteristics.

  • The electronic questionnaire assessed demographic characteristics, professional characteristics, CPR training history, and BLS knowledge.
  • The questionnaire was developed by the research team with reference to international BLS guidelines.
  • Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were used to identify associated factors.
  • CPR training history was included as one of the variables assessed but was not highlighted as a significant independent predictor in the abstract's reported findings.

What This Means

This research suggests that fewer than half (about 40%) of the healthcare professionals surveyed across multiple hospitals in Chengdu, China, had an adequate level of knowledge about Basic Life Support (BLS) — the set of emergency skills used to help someone experiencing cardiac arrest, including chest compressions and defibrillation. The study surveyed over 2,000 doctors, nurses, technicians, and other clinical staff working at different levels of hospitals (primary, secondary, and tertiary) and found that knowledge levels varied significantly depending on where people worked and what their professional role was. Doctors and nurses knew more than technicians and other clinical staff, and those working at larger tertiary hospitals knew more than those at smaller primary hospitals. The study also found that not all aspects of BLS were equally well understood. Healthcare workers scored best on core CPR knowledge (like chest compressions), with about 87% accuracy, but performed much worse on questions about defibrillation — the use of electric shocks to restore normal heart rhythm — with only about 59% accuracy. This gap is concerning because defibrillation is a critical step in treating certain types of cardiac arrest and can significantly affect survival outcomes. This research suggests that current BLS training for healthcare professionals may not be sufficient, particularly in smaller, lower-level hospitals and among staff who are not physicians or nurses. The findings point to a need for more standardized, regular, and targeted training programs that specifically address weaker knowledge areas like defibrillation, and that prioritize groups and settings where knowledge gaps are largest. Improving BLS knowledge among all healthcare workers, regardless of their role or hospital setting, could have important implications for patient survival after cardiac arrest.

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Citation

Pan P, Zhou Y, Jiang Y, Xia Y, Han T, Pan E, et al.. (2026). Knowledge-based Basic Life Support competency and associated factors among healthcare professionals across different hospital levels: a multicenter cross-sectional study.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1881120