The Importance of Implementing CPR Policy

Slightly more than half of Americans think they know how to perform cardiopulmonary resuscitation (CPR), however only one and six know the recommended technique for bystander CPR, and even fewer know the correct pace for performing chest compressions. Heart disease is the number one cause of death in the United States which directly impacts the health care system. Texas State Law Education Code 28.023 requires instruction in CPR for students grade 7 through 12, it however does not need to result in certification nor clearly states the degree of training that should occur. High school students are prime candidates to receive proper training on CPR. Therefore, having a well-designed and implemented policy in regard to CPR training within the public school system could save a life.

Legislators, the general public, those at risk for heart disease, as well as, teachers, school board members, high school students, parents and other key stakeholders should advocate for changes to this policy. The existing policy should be revised because all students in every state should receive adequate CPR training which can contribute to bystander CPR rates and increase survival rate for cardiac arrests. The recommended action is to set clear and concise guidelines for CPR training and certifications within the school system to facilitate retention and optimal learning.

Context and Importance of the Problem

The current issue at hand is related to cardiopulmonary resuscitation (CPR) training requirements for grades seven through twelve. Currently, only thirty-nine states require CPR training in high school. Cardiovascular disease is the leading cause of death for men, women and people of most racial and ethnic groups in the United States. It has been proven that bystander CPR can exponentially improve the survival rate of cardiac arrest, however, only a small number of the U.S population is trained in CPR annually. A majority of out of hospital cardiac arrest occur at home, therefore the life you could save could be a loved one.

The root of the problem is lack of utilization of the policy within the school system as well as the current procedures provided in the policy for schools to follow. To facilitate implementation of CPR training in schools, it is necessary to have clear guidelines regarding the required proficiency level to train students in CPR. Integrating efficient CPR training within the high school curriculum is both relevant and important. This is an area of opportunity to provide life changing education and training. The current school systems are not reaching the full potential to educate and train students about this highly valuable skill. More people with skills and confidence in CPR means less deaths from cardiac arrest.

Ethical Application

Two ethical principles that can be applied are beneficence and nonmaleficence. CPR can be a life saving measure and having the skills necessary to perform CPR is not only the act of doing good, but also demonstrating the duty of doing no harm. As a bystander, if you witness a cardiac arrest you have an obligation to do good and prevent harm to the person by reacting, calling 911 and performing CPR if properly trained.

Critique of Policy Options

Cardiopulmonary resuscitation instruction must include training that has been developed: 

  1. by the American Heart Association or the American Red Cross; 
  2. using nationally recognized, evidence-based guidelines for emergency cardiovascular care and incorporating psychomotor skills to support the instruction. 

Based on a survey sent out to eligible high schools that have CPR laws in their state, only 77 percent indicated they provide CPR training at their school. Lastly, not all the states have policies related to implementing CPR training within the education system. According to the Institute for Medicine (IOM), high school students may be an excellent target for CPR training.

Policy Recommendations

Measures that need to be implemented within the current policy should include requirements for hands on training. Merely watching a video does not provide adequate skills and techniques. If the training provided led to a certification, that would ensure the highest quality of training is occurring. At the system level, Congress should require each state to have a law requiring high schools to implement CPR training into the curriculum.


By setting a clear policy and enforcing it could save lives. Receiving timely CPR during out of hospital cardiac arrests can increase the survival rate. More than 325,000 lives are lost a year to cardiac arrest and only about 10% of out of hospital cardiac arrests survive. This is a major opportunity for not only improvement, but the ability to change a life.

07 July 2022
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