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Silverplats J, Södersved Källestedt ML, Äng B, Strömsöe A. Compliance with cardiopulmonary resuscitation guidelines in witnessed in-hospital cardiac arrest events and patient outcome on monitored versus non-monitored wards. Resuscitation 2024; 196:110125. [PMID: 38272386 DOI: 10.1016/j.resuscitation.2024.110125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Adherence to cardiopulmonary resuscitation (CPR) guidelines in treatment of in-hospital cardiac arrest (IHCA) have been associated with favourable patient outcome. The aim of this study was to evaluate if compliance with initial CPR guidelines and patient outcome of witnessed IHCA events were associated with the place of arrest defined as monitored versus non-monitored ward. METHODS A total of 956 witnessed IHCA events in adult patients at six hospitals during 2018 to 2019, were extracted from the Swedish Registry of Cardiopulmonary Resuscitation. Initial CPR guidelines were: ≤1 min from collapse to alert of the rapid response team, ≤1 min from collapse to start of CPR, ≤3 min from collapse to defibrillation of shockable rhythm. RESULTS The odds of compliance with guidelines was higher on monitored wards vs non-monitored wards, even after adjustment for factors that could affect staffing and resources. The place of arrest was not a significant factor for sustained return of spontaneous circulation, survival at 30 days, or neurological status at discharge, when adjusting for clinically relevant confounders. Compliance with initial CPR guidelines remained a significant factor for survival to 30 days and favourable neurological outcome at discharge regardless of other confounders. CONCLUSION Compliance with initial CPR guidelines was higher in witnessed IHCA events on monitored wards than on non-monitored wards, which indicates that healthcare professionals in monitored wards are quicker to recognize a cardiac arrest and initiate treatment. When initial CPR guidelines are followed, the place of arrest does not influence patient outcome.
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Affiliation(s)
- Jennie Silverplats
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Department of Anaesthesiology and Intensive Care, Region Dalarna, SE-79285 Mora, Sweden.
| | | | - Björn Äng
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-14186 Huddinge, Sweden; Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, SE-79182 Falun, Sweden.
| | - Anneli Strömsöe
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, SE-79182 Falun, Sweden; Department of Prehospital Care, Region Dalarna, SE-79129 Falun, Sweden.
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Silverplats J, Äng B, Källestedt MLS, Strömsöe A. Incidence and case ascertainment of treated in-hospital cardiac arrest events in a national quality registry - A comparison of reported and non-reported events. Resuscitation 2024; 195:110119. [PMID: 38244762 DOI: 10.1016/j.resuscitation.2024.110119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Approximately 2500 in-hospital cardiac arrest (IHCA) events are reported annually to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) with an estimated incidence of 1.7/1000 hospital admissions. The aim of this study was to evaluate the compliance in reporting IHCA events to the SRCR and to compare reported IHCA events with possible non-reported events, and to estimate IHCA incidence. METHODS Fifteen diagnose codes, eight Classification of Care Measure codes, and two perioperative complication codes were used to find all treated IHCAs in 2018-2019 at six hospitals of varying sizes and resources. All identified IHCA events were cross-checked against the SRCR using personal identity numbers. All non-reported IHCA events were retrospectively reported and compared with the prospectively reported events. RESULTS A total of 3638 hospital medical records were reviewed and 1109 IHCA events in 999 patients were identified, with 254 of the events not found in the SRCR. The case completeness was 77% (range 55-94%). IHCA incidence was 2.9/1000 hospital admissions and 12.4/1000 admissions to intensive care units. The retrospectively reported events were more often found on monitored wards, involved patients who were younger, had less comorbidity, were often found in shockable rhythm and more often achieved sustained spontaneous circulation, compared with in prospectively reported events. CONCLUSION IHCA case completeness in the SRCR was 77% and IHCA incidence was 2.9/1000 hospital admissions. The retrospectively reported IHCA events were found in monitored areas where the rapid response team was not alerted, which might have affected regular reporting procedures.
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Affiliation(s)
- Jennie Silverplats
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Department of Anaesthesiology and Intensive Care, Region Dalarna, SE-79285 Mora, Sweden.
| | - Björn Äng
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-14186 Huddinge, Sweden; Center for Clinical Research Dalarna, Uppsala University, SE-79182 Falun, Sweden.
| | - Marie-Louise Södersved Källestedt
- Centre for Clinical Research Västmanland, Uppsala University, Affiliated with Mälardalen University, Sweden, SE-72189 Västerås, Sweden.
| | - Anneli Strömsöe
- Department of Health and Welfare, Dalarna University, SE-79188 Falun, Sweden; Center for Clinical Research Dalarna, Uppsala University, SE-79182 Falun, Sweden; Department of Prehospital Care, Region Dalarna, SE-79129 Falun, Sweden.
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Abstract
PURPOSE This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze. METHODS This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ). RESULTS Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context. CONCLUSIONS Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.
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Affiliation(s)
- Marie-Louise Södersved Källestedt
- Källestedt Clinical Skills Center, Region Västmanland, Västerås, Sweden,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden,CONTACT Marie-Louise Södersved Källestedt School of Health, Care and Social Welfare, Mälardalen University, VästeråsSE-721 23, Sweden
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Anna Letterstål
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Silverplats J, Strömsöe A, Äng B, Södersved Källestedt ML. Attitudes towards cardiopulmonary resuscitation situations and associations with potential influencing factors—A survey among in-hospital healthcare professionals. PLoS One 2022; 17:e0271686. [PMID: 35839233 PMCID: PMC9286263 DOI: 10.1371/journal.pone.0271686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Attitudes towards cardiopulmonary resuscitation (CPR) among in-hospital healthcare professionals (HCPs) are poorly understood. The aim of this study was to evaluate attitudes towards CPR situations among in-hospital HCPs and assess associations with potential influencing factors. Materials and methods A questionnaire was distributed to 3,085 HCPs in 2009 and 2,970 HCPs in 2015–2016. The associations of influencing factors were analyzed using binary logistic regression. Results In the event of a possible cardiac arrest situation, 61% of the HCPs would feel confident in their CPR knowledge, 86% would know what to do, and 60% would be able to take command if necessary. In the latest real-life CPR situation, 30% had been worried about making mistakes or causing complications, 57% had been stressed, and 27% had been anxious. A short time since the latest real-life CPR performance and a high number of previous real-life CPR performances were associated with lower odds of worrying about making mistakes/causing complications, lower odds of feeling stressed or anxious, and higher odds of feeling calm. Regardless of previous real-life CPR experience, there were differences in attitudes between groups of professions, where physicians showed increased odds of worrying about making mistakes/causing complications and nurses showed increased odds of stress. Working on a non-monitored ward meant increased odds of stress and worrying about making mistakes/causing complications. Twelve months or more having passed since the latest CPR training course was associated with increased odds of anxiety. Conclusions Despite HCPs’ generally positive attitudes towards performing CPR in the event of a possible cardiac arrest situation, feelings of stress and anxiety were common in real-life CPR situations. Regular CPR training among all HCPs is a key factor to maintain competence and reduce anxiety. The possible effects of attitudes on performing CPR need to be studied further.
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Affiliation(s)
- Jennie Silverplats
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Anaesthesiology and Intensive Care, Region Dalarna, Mora Hospital, Mora, Sweden
- * E-mail:
| | - Anneli Strömsöe
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Department of Prehospital Care, Region Dalarna, Falun, Sweden
| | - Björn Äng
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Letterstål A, Källestedt MLS, Widarsson M, Asp M. Nursing Faculties' Perceptions of Integrating Theory and Practice to Develop Professional Competence. J Nurs Educ 2022; 61:236-241. [PMID: 35522761 DOI: 10.3928/01484834-20220303-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nursing faculties' perceptions influence nursing education. This article describes how nursing faculty perceive nursing students' development of professional competence by integrating theory and practice, and by examining how this context influences this integration. METHOD With a phenomenographic approach, interviews were conducted with nine participants and analyzed into qualitatively different categories of description. RESULTS The integration of theoretical and practical knowledge is perceived as a challenge or as naturally intertwined in the entire education, focusing mainly on individual prerequisites for learning. Perceptions of a common mission create coherence for students. Evident learning structures are needed, and there is a perceived discrepancy between nurses' competence and expectations in health care. CONCLUSION If the theory and practice gap could be perceived as a driving force for continuous learning, it could become an incentive for closer collaboration by creating structures for competence development that include individuals, teams, and organizations. [J Nurs Educ. 2022;61(5):236-241.].
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Tamás É, Södersved Källestedt ML, Hult H, Carlzon L, Karlgren K, Berndtzon M, Hultin M, Masiello I, Allvin R. Simulation educators in clinical work: the manager's perspective. J Health Organ Manag 2021; ahead-of-print:0. [PMID: 32073806 PMCID: PMC7410304 DOI: 10.1108/jhom-04-2018-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation. DESIGN/METHODOLOGY/APPROACH Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations. FINDINGS The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work. PRACTICAL IMPLICATIONS The findings might have implications for the implementation and support of simulation training programs. SOCIAL IMPLICATIONS Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff. ORIGINALITY/VALUE The study provided new insights about how simulation educators as team members affect clinical practice.
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Affiliation(s)
- Éva Tamás
- Institution for Medicine and Health, Linkopings Universitet, Linkoping, Sweden
| | | | - Håkan Hult
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Carlzon
- Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Klas Karlgren
- The Södersjukhuset Hospital and Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Berndtzon
- Metodikum - Skill Centre of Medical Simulation, Region County Jönköping, Jönköping, Sweden
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care (Sunderbyn), Umeå University, Umeå, Sweden
| | - Italo Masiello
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Renée Allvin
- Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Södersved Källestedt ML, Asp M, Letterstål A, Widarsson M. Perceptions of managers regarding prerequisites for the development of professional competence of newly graduated nurses: A qualitative study. J Clin Nurs 2020; 29:4784-4794. [PMID: 33010078 PMCID: PMC7756416 DOI: 10.1111/jocn.15522] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES To describe perceptions of managers regarding prerequisites for professional competence development of newly graduated nurses following a 1-year residency programme. BACKGROUND In general, managers are unsatisfied with the professional competence of newly graduated nurses. Therefore, they have been involved in residency programmes to support the nurses' transition from being nursing students to professional nurses. However, perceptions of managers regarding the professional competence development of nurses have been sparingly studied. DESIGN/METHODS Qualitative, descriptive study with a data-driven inductive approach with content analysis to obtain an understanding of the perceptions of nine managers through interviews. EQUATOR checklist COREQ is used (see File S1). RESULTS Three themes emerged: (a) the nurses' relationships with their teams and patients, (b) expectations regarding the development of practical skills and leadership skills and (c) prerequisites for continuing learning by supportive structures and a mutual responsibility between the manager and the nurse. Reflection was perceived by the managers as a cornerstone in the learning and development of professional competence. Learning theory was important, but learning practical clinical skills was essential for the nurses to develop competence and be able to perform their work, including being a leader of the team. Some structures discouraged continued learning in the development of professional competence, indicating a gap between the healthcare settings and the basic nursing programme. CONCLUSIONS There is a gap between the university and the healthcare settings in maintaining a structure for continued learning, which requires cooperation. This gap and tension can be a driving force for the learning process of competence development. Relationships with team members and patients are considered fundamental for developing professional competence. RELEVANCE TO CLINICAL PRACTICE To overcome the gap between the university and the healthcare settings, the managers can facilitate nurses' continued learning by creating structures for reflection.
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Affiliation(s)
| | - Margareta Asp
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Anna Letterstål
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Tamás É, Södersved Källestedt ML, Hult H, Karlgren K, Allvin R. Closing the Gap: Experienced Simulation Educators' Role and Impact on Everyday Health care. J Contin Educ Health Prof 2019; 39:36-41. [PMID: 30768445 PMCID: PMC6400642 DOI: 10.1097/ceh.0000000000000240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Trained simulation educators (SEs) usually work both at simulation centers and in everyday health care, and thus, they possess dual expertise. Experienced SEs are known to grow confident with their expanding experience, but evidence is scarce about how this affects their development as clinical professionals. The aim of this study was to explore how experienced SEs describe their role within the context of everyday health care. METHODS An explorative descriptive study including 14 semistructured interviews and 27 questionnaires was conducted with 41 experienced SEs. An inductive thematic analysis was used to identify and analyze patterns describing SEs' perceptions of the influence of their educational work on everyday health care. RESULTS The SEs' descriptions of their encounters during everyday clinical work, which were affected by the fact that they had experience of facilitating simulation training, were gathered into three main themes with three of their own subthemes: education (educational needs, routines/guidelines, and being a resource), nontechnical skills (communication, feedback, and leadership/coworkership), and clinical proficiency (situational insight, role model, and confidence in clinical practice). The insights gained and actions taken as clinical professionals are all intended to be implemented with the ultimate aim of safe patient care. DISCUSSION All the aspects of the SEs' work are perceived to be successfully translated into clinical practice and can be summarized by the main themes of education, nontechnical skills, and clinical proficiency as delineated by this study. These themes are demonstrated at the individual, team, and organizational levels through increased competence and confidence.
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Affiliation(s)
- Éva Tamás
- Dr. Tamás: Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Linköping, Linköping, Sweden. Dr. Södersved Källestedt: Clinical Skills Center, Center for Clinical Research, Uppsala University, Västerås, Sweden. Dr. Hult: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Dr. Karlgren: Department of Learning, Informatics, Management, and Ethics and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. Dr. Allvin: Clinical Skills Center, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Allvin R, Berndtzon M, Carlzon L, Edelbring S, Hult H, Hultin M, Karlgren K, Masiello I, Södersved Källestedt ML, Tamás É. Confident but not theoretically grounded - experienced simulation educators' perceptions of their own professional development. Adv Med Educ Pract 2017; 8:99-108. [PMID: 28176931 PMCID: PMC5268374 DOI: 10.2147/amep.s123517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature. OBJECTIVES To explore changes in experienced simulation educators' perceptions of their own teaching skills, practices, and understanding of teaching over time. METHODS A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis. RESULTS Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor's pedagogical development. CONCLUSION Experienced simulation educators' pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.
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Affiliation(s)
- Renée Allvin
- Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro
| | - Magnus Berndtzon
- Metodikum – Skill Centre of Medical Simulation Region County Jönköping, Jönköping
| | - Liisa Carlzon
- Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Gothenburg
| | - Samuel Edelbring
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm
| | - Håkan Hult
- Institute of Medicine and Health, Medical Faculty, Linköping University, Linköping
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care, Medical Faculty, Umeå University, Umeå
| | - Klas Karlgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm
- Department of Research, Education and Development and Innovation, Södersjukhuset Hospital, Stockholm
| | - Italo Masiello
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset Hospital, Stockholm
| | | | - Éva Tamás
- Department of Cardiovascular Diseases, Institute of Medicine and Health, Medical Faculty, University of Linköping, Linköping, Sweden
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Källestedt MLS, Berglund A, Herlitz J, Leppert J, Enlund M. The impact of CPR and AED training on healthcare professionals' self-perceived attitudes to performing resuscitation. Scand J Trauma Resusc Emerg Med 2012; 20:26. [PMID: 22480164 PMCID: PMC3352321 DOI: 10.1186/1757-7241-20-26] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 04/05/2012] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Healthcare professionals have shown concern about performing mouth-to-mouth ventilation due to the risks to themselves with the procedure. However, little is known about healthcare professionals' fears and attitudes to start CPR and the impact of training. OBJECTIVE To examine whether there were any changes in the attitudes among healthcare professionals to performing CPR from before to after training. METHODS Healthcare professionals from two Swedish hospitals were asked to answer a questionnaire before and after training. The questions were relating to physical and mental discomfort and attitudes to CPR. Statistical analysis used was generalized McNemar's test. RESULTS Overall, there was significant improvement in 10 of 11 items, reflecting various aspects of attitudes to CPR. All groups of health care professionals (physicians, nurses, assistant nurses, and "others" = physiotherapists, occupational therapists, social welfare officers, psychologists, biomedical analysts) felt more secure in CPR knowledge after education. In other aspects, such as anxiety prior to a possible cardiac arrest, only nurses and assistant nurses improved.The concern about being infected, when performing mouth to mouth ventilation, was reduced with the most marked reduction in physicians (75%; P < 0.001). CONCLUSION In this hospital-based setting, we found a positive outcome of education and training in CPR concerning healthcare professionals' attitudes to perform CPR. They felt more secure in their knowledge of cardiopulmonary resuscitation. In some aspects of attitudes to resuscitation nurses and assistant nurses appeared to be the groups that were most markedly influenced. The concern of being infected by a disease was low.
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Källestedt MLS, Berglund A, Thoren AB, Herlitz J, Enlund M. Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals. Scand J Trauma Resusc Emerg Med 2011; 19:3. [PMID: 21235765 PMCID: PMC3026050 DOI: 10.1186/1757-7241-19-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 01/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND D-CPR (Defibrillator Cardiopulmonary Resuscitation) is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR). Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators). The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. METHODS Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. RESULTS There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P < 0.001). In total, 41% of the participants used AED before and 96% of the participants used AED after the intervention (P < 0.001). Before intervention, it took a median time of 120 seconds until the AED was used; after the intervention, it took 82 seconds. CONCLUSION Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.
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Källestedt MLS, Rosenblad A, Leppert J, Herlitz J, Enlund M. Hospital employees' theoretical knowledge on what to do in an in-hospital cardiac arrest. Scand J Trauma Resusc Emerg Med 2010; 18:43. [PMID: 20691117 PMCID: PMC2924259 DOI: 10.1186/1757-7241-18-43] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 08/09/2010] [Indexed: 12/05/2022] Open
Abstract
Background Guidelines recommend that all health care professionals should be able to perform cardiopulmonary resuscitation (CPR), including the use of an automated external defibrillator. Theoretical knowledge of CPR is then necessary. The aim of this study was to investigate how much theoretical knowledge in CPR would increase among all categories of health care professionals lacking training in CPR, in an intervention hospital, after a systematic standardised training. Their results were compared with the staff at a control hospital with an ongoing annual CPR training programme. Methods Health care professionals at two hospitals, with a total of 3144 employees, answered a multiple-choice questionnaire before and after training in CPR. Bootstrapped chi-square tests and Fisher's exact test were used for the statistical analyses. Results In the intervention hospital, physicians had the highest knowledge pre-test, but other health care professionals including nurses and assistant nurses reached a relatively high level post-test. Improvement was inversely related to the level of previous knowledge and was thus most marked among other health care professionals and least marked among physicians. The staff at the control hospital had a significantly higher level of knowledge pre-test than the intervention hospital, whereas the opposite was found post-test. Conclusions Overall theoretical knowledge increased after systematic standardised training in CPR. The increase was more pronounced for those without previous training and for those staff categories with the least medical education.
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Källestedt MLS, Leppert J, Enlund M, Herlitz J. Development of a reliable questionnaire in resuscitation knowledge. Am J Emerg Med 2008; 26:723-8. [PMID: 18606333 DOI: 10.1016/j.ajem.2008.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 02/01/2008] [Accepted: 02/02/2008] [Indexed: 11/25/2022] Open
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