Abstract
Background: Cardiac arrest is a life-threatening event that requires early recognition and timely intervention. In-hospital cardiac arrest (IHCA) may be preceded by clinical deterioration, making competent monitoring, escalation, and resuscitation response essential. Cardiopulmonary resuscitation (CPR) is a key life-saving intervention, but CPR knowledge and skills may decline when healthcare professionals have limited opportunities for practice or exposure to real CPR events. Aim: This study aimed to evaluate CPR competency retention and compare knowledge and skills outcomes between nurses working in critical care and general care units. Methods and Results: A prospective comparative observational cohort study was conducted among 265 registered nurses. All participants were assessed immediately after BLS training, and each participant was reassessed once at an assigned post-training interval of 1, 3, or 6 months. Therefore, the findings represent subgroup comparisons across reassessment intervals rather than individual longitudinal trajectories across all time points. Knowledge was analyzed as a percentage score, while practical skills were analyzed categorically as Pass or Needs Remediation. Lower knowledge scores were observed at the assigned post-training reassessment intervals than at the immediate post-training assessment in both clinical groups, with clearer differences across reassessment intervals in the general care group. Skills competency also showed a higher proportion of nurses needing remediation at later intervals, particularly in the general care group. Conclusions: The findings suggest that CPR competency retention may vary across clinical settings and post-training reassessment intervals. The results support targeted refresher strategies, while acknowledging that causal explanations and individual longitudinal trajectories cannot be inferred from this design.