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Burnitt E, Grealish LA, Crilly J, May K, Ranse J. Providing end of life care in the emergency department: A hermeneutic phenomenological study. Australas Emerg Care 2024; 27:161-166. [PMID: 38310030 DOI: 10.1016/j.auec.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department. METHODS A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants' narratives was undertaken. FINDINGS Seven registered nurses were interviewed; six of whom were women. Participant's experience working in the emergency department setting ranged from 2.5-20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department. CONCLUSIONS Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.
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Affiliation(s)
- Ellie Burnitt
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
| | - Laurie A Grealish
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Gold Coast Health, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Centre for Mental Health, Griffith University, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Queensland, Australia
| | - Katya May
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Queensland, Australia
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Department of Emergency Medicine, Gold Coast Health, Queensland, Australia
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2
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Dermer J, James S, Palmer C, Christensen M, Craft J. Factors affecting ward nurses' basic life support experiences: An integrative literature review. Int J Nurs Pract 2023; 29:e13120. [PMID: 36502807 DOI: 10.1111/ijn.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/25/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Performing cardiopulmonary resuscitation in non-critical care hospital wards is a stressful event for the registered nurse; stress may negatively affect performance. Delays in initiating basic life support and following current basic life support algorithms have been reported globally. AIM The aim of this review was to investigate factors that can affect registered nurses' experiences of performing basic life support. METHODS Using the five-step integrative literature review method from Whittemore and Knafl, this review searched articles published between January 2000 and June 2022 for qualitative and quantitative primary studies from the databases CINAHL Complete (EBSCO), Medline (Web of Science), Scopus and PubMed. RESULTS Nine studies from eight countries met the inclusion criteria and were appraised here. Five themes relating to factors affecting the performance of basic life support were found during this review: staff interaction issues, confidence concerns, fear of harm and potential litigation, defibrillation concerns and basic life support training issues. CONCLUSIONS This review revealed several concerns experienced by registered nurses in performing basic life support and highlights a lack of research. Factors affecting nurses' experiences need to be understood. This will allow education to focus on consideration of human factors, or non-technical skills during basic life support training, as well as technical skills, to improve outcomes for patients experiencing an in-hospital cardiopulmonary arrest.
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Affiliation(s)
- Jennifer Dermer
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast Caboolture, Caboolture, Queensland, Australia
| | - Steven James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast Moreton Bay, Petrie, Queensland, Australia
| | - Christine Palmer
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast Caboolture, Caboolture, Queensland, Australia
| | - Martin Christensen
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Judy Craft
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast Caboolture, Caboolture, Queensland, Australia
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Koh CSL, Ong KK, Tan MML, Mordiffi SZ. Evaluation of a graduate nurse residency program: A retrospective longitudinal study. NURSE EDUCATION TODAY 2023; 126:105801. [PMID: 37060779 DOI: 10.1016/j.nedt.2023.105801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND There is an urgency to retain nurses globally. Evidence has shown that nurse residency programs promote retention of new graduate nurses. However, there is a dearth of studies examining the impact of nurse residency programs longitudinally. AIM To evaluate the impact of a transition-to-practice program on new graduate nurses' practice confidence and job satisfaction over 24 months. DESIGN A retrospective longitudinal study. SETTING A 1200-bed public tertiary academic hospital. PARTICIPANTS New graduate nurses from local universities who joined the hospital and were enrolled in the Graduate Nurse Residency Program (n = 104). METHODS The program was conducted for 24 months and consisted of modules on bedside knowledge and skills, and a mentorship program with senior nurse leaders. Practice confidence and job satisfaction were measured using the Casey-Fink graduate nurse experience survey. The survey was administered four times over the 24 months as part of the program. Data was analyzed using repeated measures ANOVA. RESULTS Practice confidence increased and job satisfaction decreased over the 24 months. Practice confidence total score at 6 months and an extended probation period were factors associated with attrition during the 24-month clinical practice. CONCLUSIONS This is the first longitudinal study to demonstrate the impact of a transition-to-practice program in a multiethnic Asian setting. The Graduate Nurse Residency Program enhanced the practice confidence of new graduate nurses.
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Affiliation(s)
- Catherine Siow Lan Koh
- Nursing Department, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 6, 119228, Singapore.
| | - Keh Kiong Ong
- Nursing Department, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 6, 119228, Singapore.
| | - Mary Mui Leng Tan
- Nursing Department, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 6, 119228, Singapore.
| | - Siti Zubaidah Mordiffi
- Nursing Department, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 6, 119228, Singapore.
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Fiori M, Coombs M, Endacott R, Cutello CA, Latour JM. What the curtains do not shield: A phenomenological exploration of patient-witnessed resuscitation in hospital. Part 2: Healthcare professionals' experiences. J Adv Nurs 2022; 78:2596-2607. [PMID: 35332562 PMCID: PMC9544000 DOI: 10.1111/jan.15219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/21/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022]
Abstract
Aims To explore healthcare professionals' experiences of patient‐witnessed resuscitation in hospital. Design Descriptive phenomenology. Methods Healthcare professionals involved in hospital resuscitation activities were recruited from medical, intensive care, resuscitation and education departments in a university hospital in England. Data were collected through face‐to‐face and focus group interviews, between August 2018 and January 2019. Data were analysed using Giorgi's phenomenological approach. Results Nine registered nurses, four healthcare assistants and seven doctors participated in four individual interviews and three focus groups. Findings were related to three themes: (1) Protecting patients from witnessing resuscitation: healthcare professionals used curtains to shield patients during resuscitation, but this was ineffective. Thus, they experienced challenges in explaining resuscitation events to the other patients and communicating sensitively. (2) Emotional impact of resuscitation: healthcare professionals recognized that witnessing resuscitation impacted patients, but they also felt emotionally affected from performing resuscitation and needed coping strategies and support. (3) Supporting patients who witnessed resuscitation: healthcare professionals recognized the importance of patients' well‐being, but they felt unable to provide effective and timely support while providing life‐saving care. Conclusion Healthcare professionals involved in hospital resuscitation require specific support, guidance and education to care effectively for patients witnessing resuscitation. Improving communication, implementing regular debriefing for staff, and allocating a dedicated professional to support patients witnessing resuscitation must be addressed to improve clinical practice. Impact The WATCH study uncovers patients' and healthcare professionals' experiences of patient‐witnessed resuscitation, a phenomenon still overlooked in nursing research and practice. The main findings highlight that, in common with patients, healthcare professionals are subject to the emotional impact of resuscitation events and encounter challenges in supporting patients who witness resuscitation. Embedding the recommendations from this research into clinical guidelines will impact the clinical practice of healthcare professionals involved in hospital resuscitation and the quality and timeliness of care delivered to patients.
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Affiliation(s)
- Martina Fiori
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.,School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Maureen Coombs
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.,School of Nursing Midwifery and Health Practice, Victoria University of Wellington, Wellington, New Zealand
| | - Ruth Endacott
- National Institute for Health Research, London, UK.,Faculty of Medicine, School of Nursing and Midwifery, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Clara A Cutello
- Faculty of Health, School of Psychology, University of Plymouth, Plymouth, UK.,Faculty of Business and Economics, Department of Marketing, University of Antwerp, Antwerp, Belgium
| | - Jos M Latour
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia.,Hunan Children's Hospital, Changsha, China
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5
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Blomquist M, Lasiter S. Nurses’ coping strategies during and after an adult in‐hospital resuscitation attempt: A scoping study. J Clin Nurs 2021; 31:2437-2449. [DOI: 10.1111/jocn.16128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/20/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Blomquist
- School of Nursing and Health Studies University of Missouri, Kansas City Kansas City Missouri USA
| | - Sue Lasiter
- School of Nursing and Health Studies University of Missouri, Kansas City Kansas City Missouri USA
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Riley K, Middleton R, Wilson V, Molloy L. Voices from the 'resus room': An integrative review of the resuscitation experiences of nurses. J Clin Nurs 2021; 31:1164-1173. [PMID: 34542206 DOI: 10.1111/jocn.16048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/25/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nurses are often the first responders to resuscitations. Understanding their experiences of resuscitation will highlight the resuscitative context nurses work within and identify the conditions that support or hamper their delivery of safe and effective resuscitative care. AIM The aim of this integrative review is to develop an understanding of nurses' experience of resuscitation, to gain knowledge of their challenges and identify gaps in evidence. DESIGN Integrative review. METHODS The electronic databases CINAHL, MEDLINE, Scopus and Web of Science were systematically searched from 2000-2021. Methodological quality of the papers was evaluated using the Mixed Methods Appraisal Tool (MMAT). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist was used to guide and report the integrative review. RESULTS Eleven articles met criteria for review. Four themes arose from the literature that addressed nurses experiences of resuscitation: Chaos (external/internal), ethical dilemmas, clinical confidence and need for support. CONCLUSION Nurses' experiences of resuscitation are multifaceted. Addressing the challenges that nurses experience during resuscitation will help ensure that nurses' are supported in their professional growth and personal well-being. Relevance to clinical practice and research: Building nursing leadership capacity within resuscitations is an area of clinical practice/research that is gaining traction as a valid solution to address the challenges nurses experience during resuscitations. Whilst the barriers to debriefing requires a greater level of consideration within the workplace.
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Affiliation(s)
- Katherine Riley
- School of Nursing, University of Wollongong, New South Wales, Australia
| | | | - Val Wilson
- School of Nursing, University of Wollongong, New South Wales, Australia
| | - Luke Molloy
- School of Nursing, University of Wollongong, New South Wales, Australia
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Mosca CG, Stein C, Lawrence H. South African pre-hospital emergency care personnel's lived experiences of managing paediatric emergencies: A qualitative research design utilising one-on-one interviews. Health SA 2021; 26:1558. [PMID: 34394964 PMCID: PMC8335770 DOI: 10.4102/hsag.v26i0.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/21/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The phenomenon of managing paediatric emergencies in the pre-hospital environment within the South African setting is poorly understood with specific regard to what emergency care personnel are experiencing when managing paediatric emergencies. AIM The aim of this study was to explore and describe the lived experiences of emergency care personnel in managing paediatric patients in the pre-hospital environment and to understand the meaning and the significance of these experiences. SETTING All participants were purposively sampled from emergency medical services agencies operating within the Johannesburg metropolitan city area. METHODS This study followed a qualitative, exploratory, descriptive, phenomenological design, whereby participants purposively sampled within the Johannesburg metropolitan city voluntarily consented to one-on-one interviews (n = 10). RESULTS Three main themes, with 11 contributing categories, were identified and contextualised with available literature. Emerging from the main themes was an overall sense that managing paediatric emergencies is a negative experience, coloured with feelings of inadequacy, stress, anxiety and even fear. CONCLUSIONS The findings of this study provided new insights into what South African EMS are experiencing when managing paediatric emergencies, which enables future research efforts to identify research and practice gaps that are relevant to paediatric pre-hospital emergency care, and that are specific to the South African environment. CONTRIBUTION This research provides preliminary insight into the lived experiences of prehospital personnel managing paediatric emergencies as well as emerging recommendations for the improvement of the prehospital care of paediatric patients.
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Affiliation(s)
- Colin G Mosca
- Department of Emergency Medical Care, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Christopher Stein
- Department of Emergency Medical Care, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Heather Lawrence
- Department of Allied Health Professions, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
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8
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Lin YP, Chan LYC, Chan E. Interprofessional collaboration during medical emergencies among doctors, nurses, and respiratory therapists in the intensive care unit: A phenomenological study protocol. J Adv Nurs 2019; 76:373-379. [DOI: 10.1111/jan.14244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Le Yi Cynthia Chan
- Department of Nursing Service Tan Tock Seng Hospital Singapore Singapore
| | - Ee‐Yuee Chan
- Department of Nursing Service Tan Tock Seng Hospital Singapore Singapore
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9
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Chua WL, Legido-Quigley H, Ng PY, McKenna L, Hassan NB, Liaw SY. Seeing the whole picture in enrolled and registered nurses’ experiences in recognizing clinical deterioration in general ward patients: A qualitative study. Int J Nurs Stud 2019; 95:56-64. [DOI: 10.1016/j.ijnurstu.2019.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/15/2019] [Accepted: 04/17/2019] [Indexed: 11/29/2022]
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10
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Impact of Patients Presenting with Alcohol and/or Drug Intoxication on In-Event Health Care Services at Mass-Gathering Events: An Integrative Literature Review. Prehosp Disaster Med 2018; 33:539-542. [PMID: 30208984 DOI: 10.1017/s1049023x1800078x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a growing body of literature relating to mass-gathering events. A common thread amongst this literature, particularly the literature relating to music festivals, is the incidence of patients presenting with substance and/or alcohol intoxication. However, the impact of alcohol and/or drugs on the provision of in-event health care services has not been explored in detail.AimThe goal of this review was to develop an understanding of the impact of alcohol and/or drugs on in-event health care services at mass-gathering events. METHOD This paper used integrative review as a methodology. The articles included in this literature review were sourced by searching databases inclusive of Medline (Ovid; US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), Scopus (Elsevier; Amsterdam, Netherlands), PsycINFO (Ovid; American Psychological Association; Washington DC, USA), and Pub Med (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA). Identified manuscripts that met the inclusion criteria were thematically analyzed. RESULTS In total, 12 manuscripts met the inclusion criteria for this review. A thematic analysis of these manuscripts identified three main themes: (i) predictive factors, (ii) patient presentation rates, and (iii) levels of care. CONCLUSION Substance use and/or intoxication can place a strain on in-event medical services at mass-gathering events. Of the various types of mass-gathering events, music festivals appear to be the most affected by substance use and intoxication. BullockM, RanseJ, HuttonA. Impact of patients presenting with alcohol and/or drug intoxication on in-event health care services at mass-gathering events: an integrative literature review. Prehosp Disaster Med. 2018;33(5):539-542.
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DeGrande H, Liu F, Greene P, Stankus JA. The experiences of new graduate nurses hired and retained in adult intensive care units. Intensive Crit Care Nurs 2018; 49:72-78. [PMID: 30172466 DOI: 10.1016/j.iccn.2018.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/11/2018] [Accepted: 08/14/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is a common practice that new graduate Registered Nurses are hired into adult intensive care units as initial entry into practise. There exists a practice readiness gap between nursing curricula and actual clinical practise expectations at adult intensive care settings; this has led to negative consequences and subsequent nurse turnover, a concern nationwide. Nonetheless, some new graduate nurses survived their initial transition and continue to practise in adult settings. The purpose of this study was to explore the experiences of nurses who were hired into adult intensive care as a new graduate and survived their transition from novice to competent, starting the third year of practise. METHODOLOGY The study used the hermeneutic phenomenology research approach. FINDINGS Data analysis revealed the overall meaning of the experience: coming to terms with being comfortable with being uncomfortable. The six themes associated with being comfortable with being uncomfortable were: confidence and uncertainty, gaining experiences and forever learning, intuitive knowing and intuition, difficult and stressful, being courageous and assertive, and the team and support people. CONCLUSION New graduate nurses can survive to become competent adult intensive care nurses. This study reveals the need to promote exposure to a variety of clinical situations early, to promote resilience and self-care, and to foster unit teamwork and mentoring to ensure successful transition and overall retention of new nurses hired into in adult intensive care.
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Affiliation(s)
- Heather DeGrande
- Texas A&M University, College of Nursing and Health Sciences: 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Fuqin Liu
- Texas Woman's University, College of Nursing: 304 Administration Dr. Denton, TX 76204, United States.
| | - Pamela Greene
- Texas A&M University, College of Nursing and Health Sciences: 6300 Ocean Dr., Corpus Christi, TX 78412, United States.
| | - Jo-Ann Stankus
- Texas Woman's University, College of Nursing: 304 Administration Dr. Denton, TX 76204, United States.
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12
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Della Ratta C. The art of balance: Preceptors' experiences of caring for deteriorating patients. J Clin Nurs 2018; 27:3497-3509. [PMID: 29920813 DOI: 10.1111/jocn.14579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 11/30/2022]
Abstract
AIM To explore nurse preceptors' experiences of caring for deteriorating patients while providing guidance and supervision to a new graduate nurse. BACKGROUND Fostering novice nurse development during high-stakes encounters may be challenging for preceptors. Despite myriad preceptor literature, there is limited published research on experience of caring for deteriorating patients while serving as preceptor to a novice nurse. DESIGN Qualitative interpretive phenomenological analysis. METHOD Data were collected through one-on-one, semistructured interviews between August 2016-September 2017 until data saturation occurred. Diekelmann's method was used to analyse the narratives of the purposive sample of 11 nurse preceptors. RESULTS The findings reveal the experience of preceptors as they balanced their role as nurse with preceptor role to ensure patient safety and novice nurse development. Supporting the novice to care portrays the ways preceptors facilitated novice nurse development in caring for deteriorating patients. Impacting the preceptor role was remembering their own novice experience. Knowing when to step in was influenced by the preceptor's clinical expertise as they came to know (or not) when it was necessary for them to assume care of the patient. Debriefing: an essential preceptor tool emerged as a critical aspect of the experience to review technical aspects of care, vent emotions and provide evaluative feedback and reassurance to the novice. CONCLUSION Preceptors' experiences of caring for deteriorating patients while precepting novice nurses require a balancing of roles to ensure patient safety and novice nurse development. Preceptors' clinical expertise was critical in knowing when to step in and assume care of the patient. RELEVANCE TO CLINICAL PRACTICE Caring for deteriorating patients while serving as preceptor to novice nurses requires clinical expertise to ensure patient safety and novice nurse development. Clinical leaders may use the findings from this study to improve preceptor development and support.
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Ranse K, Ranse J, Pelkowitz M. Third-year nursing students' lived experience of caring for the dying: a hermeneutic phenomenological approach. Contemp Nurse 2018; 54:160-170. [PMID: 29669455 DOI: 10.1080/10376178.2018.1461572] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In preparation for practice as a Registered Nurse, it is essential that students are equipped to care for the dying patient and their family. AIM To explore nursing students' lived experience of caring for a dying patient and their family. DESIGN Hermeneutic phenomenology. METHODS Students who had cared for a dying patient in their final year of study were invited to participate in an interview. Participants' narratives (n = 6) were thematically analysed. FINDINGS Analysis revealed three themes: being caring, unexpectedness in witnessing an expected death and experiencing loss. Students demonstrated family-centred care but recounted unexpectedness in both the dying trajectory and physical changes in the dying patient. When reflecting on experiencing loss, students questioned their own actions, acknowledged the value of relationships and identified ways to cope. CONCLUSIONS Engaging students in the care of dying patients and providing appropriate preparation/support can influence their experience and the care they provide in the future.
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Affiliation(s)
- Kristen Ranse
- a School of Nursing & Midwifery, Gold Coast Campus , Griffith University , Southport , Queensland , Australia.,b School of Nursing & Midwifery, Faculty of Health , University of Canberra , Canberra , Australia
| | - Jamie Ranse
- a School of Nursing & Midwifery, Gold Coast Campus , Griffith University , Southport , Queensland , Australia.,c Department of Emergency Medicine , Gold Coast Hospital and Health Services , Southport , Queensland , Australia
| | - Mikayla Pelkowitz
- b School of Nursing & Midwifery, Faculty of Health , University of Canberra , Canberra , Australia
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14
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Lee MR, Cha C. Emergency department nurses' experience of performing CPR in South Korea. Int Emerg Nurs 2017; 38:29-33. [PMID: 29050836 DOI: 10.1016/j.ienj.2017.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/16/2017] [Accepted: 09/25/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emergency Department (ED) nurses often confront unexpected cardiopulmonary resuscitation (CPR) with little information about the patients. METHODS This qualitative study explored the experience of performing CPR among ED nurses. Data collection took place between May and June 2016 using an online advertisement to recruit 17 ED nurses. Each participant was interviewed for 40-90min. Interviews were recorded and transcribed verbatim. Data analysis was conducted using a conventional content-analysis method. RESULTS Four themes emerged: Pressure from the urgency of the CPR, becoming sharp tempered in addressing personnel during CPR, keeping psychological conflicts of CPR patient care to oneself, and growing as an ED nurse through CPR. CONCLUSION ED nurses had anxiety about CPR, regardless of their ability to perform CPR. They also suffered psychologically afterward. ED nurses could benefit from education that promotes their competencies for CPR and support systems to alleviate their psychological distress.
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Assarroudi A, Heshmati Nabavi F, Ebadi A, Esmaily H. Professional Rescuers' experiences of motivation for cardiopulmonary resuscitation: A qualitative study. Nurs Health Sci 2017; 19:237-243. [PMID: 28247467 DOI: 10.1111/nhs.12336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/25/2016] [Accepted: 12/31/2016] [Indexed: 11/29/2022]
Abstract
Rescuers' psychological competence, particularly their motivation, can improve the cardiopulmonary resuscitation outcomes. Data were collected using semistructured interviews with 24 cardiopulmonary resuscitation team members and analyzed through deductive content analysis based on Vroom's expectancy theory. Nine generic categories were developed: (i) estimation of the chance of survival; (ii) estimation of self-efficacy; (iii) looking for a sign of effectiveness; (iv) supportive organizational structure; (v) revival; (vi) acquisition of external incentives; (vii) individual drives; (viii) commitment to personal values; and (ix) avoiding undesirable social outcomes. When professional rescuers were called to perform cardiopulmonary resuscitation, they subjectively evaluated the patient's chance of survival, the likelihood of achieving of the desired outcome, and the ability to perform cardiopulmonary resuscitation interventions. If their evaluations were positive, and the consequences of cardiopulmonary resuscitation were considered favorable, they were strongly motivated to perform it. Beyond the scientific aspects, the motivation to perform cardiopulmonary resuscitation was influenced by intuitive, emotional, and spiritual aspects.
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Affiliation(s)
- Abdolghader Assarroudi
- Department of Medical Surgical Nursing, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Heshmati Nabavi
- Department of Nursing Management, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Habibollah Esmaily
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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16
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Della Ratta C. Challenging graduate nurses' transition: Care of the deteriorating patient. J Clin Nurs 2016; 25:3036-48. [PMID: 27524113 DOI: 10.1111/jocn.13358] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2016] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVE To explore graduate nurses' experiences of caring for deteriorating patients during the first year of practice. BACKGROUND Hospital-based transition programmes have been established to ease graduate nurse transition. Despite this, novice nurses persistently cite caring for deteriorating patients as a clinical challenge. Few studies have explored the unique needs of novice nurses during such encounters, even less research has been undertaken from their perspective. DESIGN Qualitative interpretive phenomenological analysis. METHOD One-on-one, semi-structured, in-depth, audio-recorded interviews were conducted between July-November 2014. A purposive sample of eight novice nurses working in acute care, ICU and the ED was recruited through the use of flyers. RESULTS Three major patterns with related themes illuminate the experience of caring for deteriorating patients as it is lived by graduate nurses. Dwelling with uncertainty occurred during initial encounters with deteriorating patients with its deeply felt impact upon these novices causing them to question their capability of becoming a nurse. 'Success' or 'failure' of their performance during these encounters extended to their view of themselves as nurses and impacted transition. Building me up was influenced by participants' expressed need for and importance of trusted relationships with preceptors, nurse colleagues and/or educators as they learned to care for deteriorating patients. A new lifeline: Salient being emerged as change in participants' identity and increased self-understanding as professional nurses. CONCLUSION Caring for deteriorating patients impacted graduate nurses because they viewed such encounters to be 'high stakes' not only for their patient but also for themselves. Crucial to their development were trusted relationships with preceptors, nurse colleagues and/or educators. RELEVANCE TO CLINICAL PRACTICE The findings identify needs of graduate nurses' during a high-stakes patient encounter and shed light upon one aspect of transition. Clinical leaders may use the findings from this study to improve preceptor development and transition programme curricula.
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Affiliation(s)
- Carol Della Ratta
- Department of Undergraduate Studies, School of Nursing, Stony Brook University, Stony Brook, NY, USA.
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Mental Well-being Considerations in Preparation for Disaster Health Care: Learning From Deployment. Prehosp Disaster Med 2015; 30:327-36. [PMID: 26052669 DOI: 10.1017/s1049023x1500477x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The mental well-being of internationally deployed disaster-relief workers has become an issue of concern. The psychological consequences for the relief worker being exposed to trauma and threats have been well documented; however, the role of pre-deployment preparation in supporting mental well-being has not received due attention, despite research indicating the need for it. HYPOTHESIS/PROBLEM This case series examines the experiences of deployed volunteers of one emergency-relief organization. The aim of this research was to identify the participants' interpretations of the appropriateness of the pre-deployment preparation they had received in light of supporting their mental well-being during and after deployment. The main research questions were: How appropriate was pre-deployment preparation in supporting mental well-being? What elements were lacking, and what else would be useful? METHODS Using a hermeneutic phenomenological approach, thematic, semi-structured interviews were conducted with six deployed volunteers of an international emergency-relief organization. Data were analyzed using content analysis. RESULTS The participants in this study regarded the pre-deployment preparation they had received, on the whole, as appropriate in supporting their mental well-being. The seven main themes identified as important and supportive of mental well-being were: (1) realistic expectations, (2) team building and support, (3) self-awareness and self-care, (4) post-deployment support, (5) practical skills and creative solutions, (6) shared values and beliefs, and (7) safety and security. Specific areas identified as lacking within these themes included communication, self-care, post-deployment support, and safety and security. CONCLUSION Themes identified as important for supporting mental well-being in this research largely were consistent with those in previous research. The generally positive experiences of the support received do not reflect results from existing research, where significant shortcomings in worker support have been expressed. However, important elements were also identified as lacking in this specific pre-deployment preparation.
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Sjöberg F, Schönning E, Salzmann-Erikson M. Nurses' experiences of performing cardiopulmonary resuscitation in intensive care units: a qualitative study. J Clin Nurs 2015; 24:2522-8. [DOI: 10.1111/jocn.12844] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Fredric Sjöberg
- Faculty of Health and Occupational Studies; University of Gävle; Gävle Sweden
| | - Emil Schönning
- Faculty of Health and Occupational Studies; University of Gävle; Gävle Sweden
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What Was the Role of Nurses During the 2011 Great East Earthquake of Japan? An Integrative Review of the Japanese Literature. Prehosp Disaster Med 2014; 29:275-9. [DOI: 10.1017/s1049023x14000405] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundAn earthquake and tsunami hit the east coast of Japan on March 11, 2011. Nurses were actively involved in the health response to this disaster and, subsequently, many authors have reported on the role nurses played in these efforts in Japanese nursing professional journals.AimTo describe the role of nurses who assisted in the 2011 Great East Earthquake of Japan by reviewing Japanese literature and reporting the findings in English.MethodThis research used an integrative literature review methodology. Manuscripts were obtained from the Japanese database Ichushi Ver. 5 (Japan Medical Abstracts Society, Tokyo, Japan). A total of 44 manuscripts were identified and included in a thematic analysis.ResultsThree main themes were identified: (1) nursing roles, (2) specialized nursing roles, and (3) preparedness education. Nurses fulfilled different roles in the period after the disaster (ie, as a clinician, a communicator, a leader, and a provider of psychosocial support). Additionally, the specialized nurse role was identified, along with the need for preparedness education to support the nurse's role in a disaster.ConclusionThe understanding of the role of nurses in disasters is expanding. There is a need to further explore the roles of specialized nurses in disasters. Further disaster education opportunities should be available as a part of continuing education for all nurses. Radiation aspects of disaster assistance should be included in disaster education programs where there are radio-nuclear hazards present in the environment.KakoM, RanseJ, YamamotoA, ArbonP. What was the role of nurses during the 2011 Great East Earthquake of Japan? An integrative review of the Japanese literature. Prehosp Disaster Med. 2014;29(3):1-5.
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Molan EL. Scribe during emergency department resuscitation: Registered Nurse domain or up for grabs? AUSTRALASIAN EMERGENCY NURSING JOURNAL : AENJ 2013; 16:45-51. [PMID: 23773535 DOI: 10.1016/j.aenj.2013.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 03/04/2013] [Accepted: 03/04/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Scribe nurses within metropolitan emergency departments are traditionally Registered Nurses who document the resuscitation event to provide a true and timely representation of what occurred. Enrolled Nurses undertake the scribe role in some Australian emergency department resuscitations, particularly in rural and remote health services. There is no Australian research evidence pertaining to the role of the scribe nurse within a resuscitation team. This study explored the scribe role and the nursing work involved within it to appraise whether it is appropriate to delegate the responsibility away from Registered Nurses. METHOD Using a qualitative descriptive design, semi-structured interviews were conducted with eight Registered Nurses who had emergency department scribe nurse experience. Thematic analysis was adopted to identify common threads within the interview data. RESULTS The four themes identified were the role, scribe effectiveness, expertise and 'scribe by default'. Participants were generally positive regarding the potential for Enrolled Nurses to scribe in metropolitan emergency department resuscitation teams. CONCLUSION The characteristics of an effective scribe; well developed communication skills, confidence and assertiveness and resuscitation 'know how', may be the measurement of readiness for the position of scribe nurse within the resuscitation team, rather than number of years of clinical experience or designation.
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Affiliation(s)
- Emily L Molan
- University of Canberra, Disciplines of Nursing & Midwifery, Bruce, ACT 2601, Australia.
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Abstract
Little is known about the current training and barriers in resuscitation skills among practicing ward nurses. A convenience sample of 459 ward nurses, recruited from 11 academic teaching hospitals in Korea, were surveyed to assess current training and barriers to optimal resuscitation performance on the wards. The Perceived Barriers scale was developed, refined, and its psychometric properties were assessed. Approximately 36% of nurses had received simulation-based resuscitation skills training. Exploratory factor analysis identified four barriers accounting for 58.4% of the variance: insufficient training (37.7%), lack of competence (9.8%), lack of self-confidence (5.9%), and workload and tension (5.1%). Strategic planning and resuscitation skills training should be incorporated into staff development programs to reduce barriers to optimal resuscitation performance and cope with work demands for ward nurses.
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Affiliation(s)
- Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University (CAU), CAU Healthcare system, Seoul, Korea
| | | | - Hyun Soo Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
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Purling A, King L. A literature review: graduate nurses' preparedness for recognising and responding to the deteriorating patient. J Clin Nurs 2012; 21:3451-65. [DOI: 10.1111/j.1365-2702.2012.04348.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Lindy King
- School of Nursing & Midwifery, Flinders University; Adelaide; SA; Australia
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Rajeswaran L, Ehlers VJ. Audits of emergency trolleys’ contents in selected hospitals in Botswana. Health SA 2012. [DOI: 10.4102/hsag.v17i1.621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana’s hospitals’ wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys’ contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys’ equipment and supplies had been up to standard.OpsommingHartarres is ‘n lewensbedreigende noodsituasie. Die uitkoms word bepaal deur tydige en effektiewe kardio-pulmonale resussitasie (KPR). Suksesvolle KPR pogings in hospitale vereis goed toegeruste noodtrollies en toerusting wat behoorlik funksioneer, asook personeellede wat bedrewe is in die uitvoering van KPR. Die studie het gepoog om te bepaal of die noodtrollies in Botswana se hospitaalsale of eenhede aan die verwagte standaarde voldoen. Die inhoud van die noodtrollies in 20 sale of enhede van twee van Botswana se hospitale is ge-ouditeer deur ‘n gestandardiseerde kontrolelys te benut. Geen hospitaalsaal of eenheid het al die verwagte toerusting of drogerye op sy noodtrollie gehad nie, sommige eenhede het nie hulle noodtrollies se inhoud gereeld gekontroleer nie. Al 20 hospitaalsale of eenhede wat aan die studie deelgeneem het, moet die inhoud en instandhouding van hulle noodtrollies verbeter, anders kan in-hospitaal KPR pogings in Botswana tot mislukkings gedoem wees, waardeur lewens verloor word wat gered kon gewees het, indien die noodtrollies se inhoud op standaard was.
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Beyond a clinical role: nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009. ACTA ACUST UNITED AC 2012; 15:156-63. [PMID: 22947688 DOI: 10.1016/j.aenj.2012.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 03/15/2012] [Accepted: 05/16/2012] [Indexed: 11/24/2022]
Abstract
AIM This research explores the roles of nurses that participated in the Black Saturday and Victorian bushfires in February 2009, including aspects that influence nurses' roles, such as prior education, training and availability of resources. BACKGROUND It is acknowledged that nurses play an important role in disaster response and recovery. However, our understanding of nurses' roles is superficial and commonly based on descriptions of events in which specifics relating to the nurses' roles are embedded within other topics or issues. Similarly, aspects that support nurses in the disaster environment, including previous experience, education and the provision of resources, are not well understood. METHOD Single, semi-structured telephone interviews were conducted with 11 volunteer nursing members of St John Ambulance Australia. These interviews were electronically recorded, transcribed verbatim and thematically analysed using a well-recognised human science approach. FINDINGS The thematic analysis identified two broad themes: being prepared and having an expansive role. Participants indicated that they were educationally prepared and had adequate clinical experience. They outlined that they took many resources with them; however, they were used very little, as their role consisted of minimal clinical care. Additionally, nurses performed roles including a psychosocial supporter, a coordinator of care and resources, and problem solvers. CONCLUSIONS The nurses' role in providing health care during and/or following a disaster is more than a clinical care role. This understanding should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.
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Abstract
AbstractBackground:At a large public event, or mass gathering, various factors influence patient presentations that brings challenges to patient care. The chain of survival has been investigated in the prehospital setting. However, this has not explicitly included the mass-gathering environment.Objective:This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.Methods:This case-series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.Results:The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, ‘early planning’. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.Conclusions:This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique “early planning” link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.
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Neves LMT, Silva MSVD, Carneiro SR, Aquino VDS, Reis HJL. Conhecimento de fisioterapeutas sobre a atuação em suporte básico de vida. FISIOTERAPIA E PESQUISA 2010. [DOI: 10.1590/s1809-29502010000100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O estudo visou avaliar o conhecimento de fisioterapeutas e graduandos em Fisioterapia sobre diagnóstico e atendimento de urgência à parada cardiorrespiratória. A amostra foi composta de 72 estudantes e 108 fisioterapeutas, dos quais 64 atuam no ambiente extra-hospitalar e 44 no ambiente hospitalar. Foi aplicado aos participantes um questionário sobre ressuscitação cardiopulmonar (RCP) baseado nas diretrizes da American Heart Association de 2005. As respostas foram analisadas estatisticamente. Quanto ao diagnóstico da parada cardíaca, os grupos comportaram-se de maneira semelhante, optando pela avaliação da"presença de pulso e respiração". Quanto à seqüência de atendimento da RCP, a seqüência preconizada foi corretamente indicada por 52,8% do grupo estudante, 65,9% do subgrupo hospitalar e 40,6% do subgrupo extra-hospitalar. Quanto à relação compressão/ventilação, apenas 4,1% do grupo estudante, ninguém do extra-hospitalar e 25% do subgrupo hospitalar indicaram a relação preconizada atualmente. Quase todos (94%) os participantes reconheceram a importância do conhecimento em RCP para o fisioterapeuta. Assim, a maioria dos atuais e futuros fisioterapeutas reconhecem a importância da RCP para sua atuação profissional, mas têm conhecimento insuficiente sobre o tema e apenas uma pequena parcela busca atualizar-se.
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Destruction of Conventional and Chemical Weapons from World War I (1914–1918), Ieper, Belgium—Example of Long-term Problems after War Situations. Prehosp Disaster Med 2005. [DOI: 10.1017/s1049023x00014096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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