ArticleInternational journal of emergency medicine2026
Unravelling technical domain barriers and non-technical skill barriers among interprofessional teams during in-hospital cardiac arrest: a questionnaire-based survey.
Article in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn 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.
methodsA 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.
resultsThere 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).
conclusionBoth NTS barriers and technical domain barriers were associated with perceived non-adherence to high-quality CPR.
trial registrationClinical Trial Registry of India CTRI/2025/05/086727 registered on 13/05/2025.
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