<![CDATA[Background: High-quality cardiopulmonary resuscitation (CPR) is physically and cognitively demanding, while rescuer fatigue can reduce chest-compression performance. Human Factors and Ergonomics (HFE) provides a systems-based approach integrating posture, workload, teamwork, technology, and the clinical environment. Purpose: To synthesize primary evidence regarding the effects of HFE-informed CPR education and performance strategies on rescuer fatigue and CPR quality. Method: This systematic review followed the PRISMA 2020 guidelines. PubMed, ScienceDirect, SpringerLink, and Google Scholar were searched for peer-reviewed primary studies published between January 2020 and December 2025. Eligible studies examined at least one HFE component and reported fatigue, CPR-quality, or team-performance outcomes. Twenty primary studies were included, critically appraised using design-appropriate Joanna Briggs Institute tools, and narratively synthesized because of methodological heterogeneity. Results: Real-time feedback, ergonomically appropriate positioning, workload management, planned compressor rotation, effective leadership, and team-based simulation generally improved compression depth, compression rate, chest-compression fraction, and team coordination. Conversely, prolonged chest compressions, suboptimal posture, forward leaning, personal protective equipment, and demanding patient positions increased rescuer fatigue. Nevertheless, evidence directly evaluating a comprehensive HFE-based CPR training program specifically for nurses remained limited. Conclusion: HFE-informed strategies can improve immediate CPR performance, strengthen team coordination, and support fatigue management. However, a standardized nurse-focused HFE training program should be evaluated through robust multicenter clinical studies assessing fatigue, CPR quality, skill retention, musculoskeletal effects, and patient-centered outcomes.]]>
