Knowledge and attitudes toward advanced cardiac life support among healthcare professionals in Addis Ababa, Ethiopia: a multicenter cross-sectional study

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BACKGROUND: Advanced Cardiac Life Support (ACLS) supports the management of cardiac arrest and other life-threatening cardiovascular emergencies. Studies from resource-limited settings have identified persistent gaps in ACLS knowledge and attitudes among healthcare professionals. METHODS: This multicenter institution-based cross-sectional study was conducted from June to November 2024; data were collected from October to November 2024. Four referral hospitals were selected by convenience, and eligible healthcare professionals within those hospitals were selected by computer-generated simple random sampling. Data were collected using a structured, self-administered questionnaire. Good knowledge was defined as at least 7 correct answers among 14 questions. Attitude was measured with 12 five-point Likert items; participants with an aggregate score at or above the sample mean were classified as having a positive attitude. Data were analyzed using SPSS version 28. Multivariable logistic regression identified factors associated with knowledge and attitude, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. RESULTS: Of 397 sampled healthcare professionals, 379 completed the survey (response rate, 95.5%). Overall, 178 (47.0%) had good ACLS knowledge and 164 (43.3%) had a positive attitude. Nurses had higher adjusted odds of good knowledge than physicians (AOR, 2.09; 95% CI, 1.26-3.42). Participants with MSc-level education had lower adjusted odds of good knowledge than degree holders (AOR, 0.38; 95% CI, 0.16-0.92). For positive attitude, lower adjusted odds were observed among participants with 0-23 months (AOR, 0.20; 95% CI, 0.049-0.84) or 60-120 months (AOR, 0.17; 95% CI, 0.04-0.71) of experience than among those with more than 120 months, and among diploma holders than among degree holders (AOR, 0.41; 95% CI, 0.21-0.78). Previous ACLS training was not significantly associated with either outcome. CONCLUSION: Fewer than half of participants had good ACLS knowledge or a positive attitude. These findings identify educational gaps and support consideration of accessible, competency-oriented ACLS education, accompanied by local evaluation of practical performance and patient outcomes. TRIAL REGISTRATION: N/A CLINICAL TRIAL NUMBER: Not applicable.

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