Qualitative exploration of challenges in cardiopulmonary resuscitation within pediatric intensive care units (PICU)

Abstract

Cardiopulmonary resuscitation (CPR) in the Pediatric Intensive Care Unit (PICU) is a vital, sensitive, and complex process that has a direct impact on patient survival and prognosis. Any disruption during the resuscitation process may lead to irreversible consequences. However, various challenges can affect the efficacy of resuscitation efforts. The aim of this study was to explore the experiences of resuscitation team members regarding the challenges associated with CPR in the PICU, utilizing a conventional qualitative content analysis approach. This study employed a conventional qualitative content analysis. Participants were selected through purposive sampling with maximum variation among members of the resuscitation team. Data were collected via in-depth, semi-structured interviews conducted between September 2024 and March 2025 in Kermanshah city, Iran, and data were organized and managed using MAXQDA 2020 software. Data analysis was guided by the approach proposed by Graneheim and Lundman (2004). In total, eleven members of the resuscitation team were interviewed, including seven nurses, two anesthesia technicians, and two pediatric residents. Data analysis yielded four main categories: educational challenges, human-related challenges, organizational challenges and Obstacles, and practical challenges, along with eleven subcategories. The findings of this study indicate that the CPR process in the PICU is confronted with multiple challenges across educational, human, organizational, and practical domains. Identifying these challenges may provide a foundation for designing effective interventions in training, enhancing organizational infrastructure, and improving interprofessional coordination, ultimately leading to improved resuscitation quality and increased patient survival rates.