Every Second Counts: A Cross‐Sectional Analysis of Critical Care Nurses' Knowledge and Attitude Toward Prone Cardiopulmonary Resuscitation

BACKGROUND: Prone cardiopulmonary resuscitation (CPR) emerges as a vital and lifesaving intervention for patients positioned prone with an advanced airway in intensive care, emergency or surgical settings. Prone position CPR is recommended for patients in intensive care, emergency departments or surgical settings who are already positioned prone with an advanced airway. AIM: This study aimed to assess the knowledge and attitudes of critical care and emergency nurses regarding the practice of prone cardiopulmonary resuscitation (CPR), with the goal of identifying educational gaps and informing future training strategies. STUDY DESIGN: A cross-sectional survey was conducted among randomly selected nurses working in emergency departments, critical care units and intensive care units in Saudi Arabia. Data were collected using a structured self-administered questionnaire distributed through an electronic form. The survey included demographic details, a 20-question knowledge assessment (scored as excellent [75%-100%], good [50%-74%] or poor [< 50%]), and a 15-item Likert scale attitude assessment (scored 1-5, reverse-coded for negative statements). RESULTS: A total of 192 nurses participated in the study, yielding a 90% response rate. Among the respondents, 78.1% were female. Overall knowledge of prone CPR was poor (5.93 ± 2.37), with 91.7% of respondents demonstrating inadequate knowledge (< 10 correct answers). Knowledge was highest in relation to dysrhythmia medications (40.36 ± 36.16) and supine CPR quality (35.68 ± 33.40), and lowest regarding chest compression techniques and hand placement during prone CPR (24.91 ± 18.53). Attitudes were moderately favourable (45.01 ± 4.60). A statistically significant but weak positive correlation was observed between knowledge and attitudes (r = 0.222, p = 0.002). CONCLUSIONS: The findings indicate that nurses possess insufficient knowledge but moderately favourable attitudes toward prone CPR. These results underscore the urgent need for targeted, hands-on training interventions, particularly those that incorporate simulation-based scenarios involving prone resuscitation. RELEVANCE TO CLINICAL PRACTICE: Integration of prone CPR into certified training and continuing education programmes may enhance the competence and preparedness of critical care nurses. Clinically, the technique supports effective circulation and airway management in prone patients, with potential implications for improved survival outcomes.