# Study protocol – A Randomized controlled trial of efficacy of metronome on quality of chest compressions during simulated cardiopulmonary resuscitation among novice nurses

**Authors:** Mohanraj Harikrishnan, Eswari Solayappan, Shreedevi Gandhamaneni, Renuka MK, Ravishankar Nagaraja, Sharon Sheeba T, Ramesh Chandrababu

PMC · DOI: 10.1016/j.mex.2026.103818 · MethodsX · 2026-02-09

## TL;DR

This study tests if using a metronome improves chest compression quality during CPR for novice nurses in a simulated setting.

## Contribution

The study introduces a simple metronome tool to enhance CPR performance among novice nurses.

## Key findings

- Novice nurses using a metronome may achieve better compression accuracy and consistency.
- The study compares pre- and post-intervention CPR performance in a controlled simulation.
- It hypothesizes that metronome guidance significantly improves chest compression quality.

## Abstract

High-quality chest compressions are essential for effective cardiopulmonary resuscitation (CPR), but novice nurses often struggle with maintaining the right compression rate, depth, and recoil. Simple tools like metronomes can help improve cardiopulmonary resuscitation quality by providing a steady rhythm for better performance.

The objective is to evaluate whether metronome-guided CPR improves the quality of chest compressions performed by novice nurses in a simulated setting

This single-centric study of a simulation-based randomized controlled trial consists of 160 novice nurses divided equally into intervention and control groups (80 each).

Both groups performed a pre-test consisting of a 2-minute compression-only CPR session on a Q-CPR manikin without metronome guidance. After a 20-minute rest interval to prevent fatigue, the intervention group performed another 2-minute compression-only CPR session using a metronome set at 110 compressions per minute delivered. The control group repeated the CPR session under standard conditions without metronome assistance.

This study hypothesizes that novice nurses using a metronome throughout simulated cardiopulmonary resuscitation will achieve significantly higher quality chest compressions compared to those who do not use a metronome. It is expected that metronome-guided cardiopulmonary resuscitation will enhance the accuracy, depth, and consistency of compressions.

Image, graphical abstract

## Full-text entities

- **Diseases:** neurological deficits (MESH:D009461), fatigue (MESH:D005221), musculoskeletal disorders (MESH:D009140), chest (MESH:D013898), Cardiac arrest (MESH:D006323), cardiovascular conditions (MESH:D002318)
- **Chemicals:** Opaque (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12930073/full.md

## References

22 references — full list in the complete paper: https://tomesphere.com/paper/PMC12930073/full.md

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Source: https://tomesphere.com/paper/PMC12930073