Cardiopulmonary resuscitation competencies of nurses

Training and Willingness to Perform Bystander Basic Life Support

Objectives

To evaluate the perceived ability and willingness of people to perform basic life support (BLS), to relate this to those most at risk of sudden cardiac death, and to identify groups of National Health Service (NHS) staff who could benefit from training in BLS.

Design

Prospective, survey.

Setting

The Accident and Emergency (A&E) department based at Glasgow Royal Infirmary.

Subjects

All patients, accompanying persons and NHS staff who were able, willing and waiting in the A&E department.

Methods

Subjects were asked to complete a proforma with questions relating to their experience and training in BLS. Their recognition of the importance of defibrillation in the light of current European guidelines for BLS was tested.

Results

718 proformas were completed. Fifty-seven percent non-clinical NHS staff had received no training in BLS. More than 50% subjects had relatives with risk factors of Ischaemic Heart Disease yet had no training in BLS. Seventy percent ambulance men and 50% clinical NHS personnel would perform mouth to mouth ventilation before calling an ambulance where they were required to perform BLS, as a bystander. Seventy percent non-clinical NHS personnel and non NHS subjects would call an ambulance first.

Conclusions

Non-clinical NHS personnel form a hospital based group that could be trained in BLS, some of whom could assume an instructor role. A proportion of clinical and emergency personnel would not prioritise an early call for a defibrillator over BLS in the out of hospital setting.

Revisiting CPR Knowledge and Skills Among Registered Nurses

The purpose of this investigation was to explore facets involved in the retention of the cognitive knowledge and psychomotor skills of cardiopulmonary resuscitation (CPR) by 73 RNs from three general hospitals. Data analysis indicated that cognitive knowledge was adequately retained but that skills were not. Product-moment correlation coefficients showed that the number of CPR courses taken, certification as a CPR instructor, the number of years certified, and time since last certification were significantly related to skill scores. Findings prompt questions of appropriateness of the usual certification procedures for hospital-based RNs.

Bystander CPR in prehospital coarse ventricular fibrillation

Prehospital bystander cardiopulmonary resuscitation (CPR) was studied to determine if it affected the outcome of defibrillation. Four hundred twenty-one consecutive witnessed cardiopulmonary arrests presenting with the initial rhythm of coarse ventricular fibrillation treated by the Milwaukee County Paramedic System from January 1980 to June 1982 were analyzed. Pediatric, trauma, and poisoning patients and those receiving intravenous or endotracheal medications before defibrillation (58) were excluded. Immediate professional bystander CPR (physician, nurse, EMT) and citizen bystander CPR were compared to a control group receiving no bystander CPR until arrival of EMS personnel. A successful defibrillation occurred if defibrillation prior to administration of medication produced an effective cardiac rhythm with pulses. Eighty-eight of the 363 remaining patients (24%) converted with initial defibrillations. While the group receiving professional bystander CPR had a higher successful defibrillation rate than did the no-CPR group (35% vs 22%, P less than .04), citizen bystander CPR and no-CPR groups had similar successful defibrillation rates (24% vs 22%, no significant difference). One hundred eighty-six of the 363 patients (51%) were transported to a hospital with a rhythm and a pulse (a successful resuscitation). Ninety-seven of the 363 patients (27%) were discharged alive from the hospital (a save). Patients who were converted successfully using initial "quick-look" defibrillations were far more likely to be successfully resuscitated (79/88 [90%] vs 107/275 [39%], P greater than .0001) and to be discharged alive from the hospital (54/88 [61%] vs 43/275 [16%], P greater than .0001) than were those who required further advanced cardiac life support techniques.(ABSTRACT TRUNCATED AT 250 WORDS)