Nurses' role in the early defibrillation of cardiac patients: Implications for nursing in Hong Kong
Iris Sui Fong Lee
Ruttonjee and Tang Siu Kin Hospitals, Queen’s Road East Central, Wan Chai, Hong Kong
Lisa Pau Le Low
Professional Consultant, Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin NT, Hong Kong
PP: 088 - 094
Abstract
The time taken to initiate early defibrillation is crucial to improve survival, prevent neurological deficit and improve the quality of life of patients suffering from sudden cardiac arrest. Despite the extension of training and the authorization of nurses to perform early defibrillation (advocated by the American Heart Association), such practice has not been widely adopted in hospitals. Inadequate knowledge, lack of skill retention, insufficient organizational support and the passive culture of nurses are barriers preventing the move towards nurse-led defibrillation.
This paper discusses the need to extend the registered nurses' role in the early defibrillation of cardiac patients in Hong Kong. Current nursing practice in emergency resuscitation care and the hurdles constraining early defibrillation will be discussed. Recommendations to facilitate the future development of nurse-led defibrillation will also be provided. The successful extension of the registered nurses' role in early defibrillation will enable them to possess broader knowledge to be clinically competent in providing efficient patient care.
Keywords
nurse-led defibrillation; nursing practice; cardiac patients; Hong Kong
References
American Heart Association (2005) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 5: Electrical therapies automated external defi brillators, defi brillation, cardioversion and pacing. Circulation 112, IV-35-IV46. Retrieved 14 May 2010 from http://circ.ahajournals.org/cgi/reprin/112/24_suppl/IV-35
American Heart Association (2005a) American Heart Association announces updated emergency care guidelines. Retrieved 14 May 2010 from http://www.tcsems.org/medic/training/docs/newsrelease.pdf
American Heart Association & International Liaison Committee on Resuscitation (2000) An international consensus on science. Resuscitation 46(1-3), 135-153.
Aufderheide T, Hazinski MF, Nichol G, Steffens SS, Buroker A, McCune R, et al. (2006) AHA policy recommendation: community lay rescuer automated external defibrillation programs - key state legislative components and implementation strategies: A summary of a decade of experience for healthcare providers, policymakers, legislators, employers, and community leaders from the AHA Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy. Circulation 113(9), 1260-1270.
Bunch TJ, White RD, Gersh BJ, Shen WK, Hammill SC and Packer DL (2004) Outcomes and in-hospital treatment of out-of-hospital cardiac arrest patients resuscitated from ventricular fibrillation by early defibrillation. Mayo Clinic Proceedings 79(5), 613-619.
Burdick WP and Cone DC (2004) Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation. Annals of Emergency Medicine 43(3), 424-425.
Chan WK, Kung NNS, Ma MC, Ng WP, Chan S and Lau FL (1998) Emergency defibrillation performed by coronary nursing staff: A pilot study. Hong Kong Medical Journal 4(1), 47-51.
Dwyer T, Williams LM and Jacobs I (2004) The benefits and use of shock advisory defibrillators in hospitals. International Journal of Nursing Practice 10(2), 86-92.
Eastwick-Field P (1996) Introduction nurse-initiated management of cardiac arrest. Nursing Standard 10(26), 46-48.
Eastwick-Field P (1996a) Resuscitation: Advanced life support. Nursing Standard 10(50), 49-56.
Finn J and Jacobs I (2004) Position Statement: The role of nurses in the management of cardio-respiratory arrest. Board of Royal College of Nursing, Australia. Retrieved 14 May 2010 from www.rcna.org.au/_literature_32169/Role_of_nurses_in_the_management_of_cardiorespiratory_arrest_(2006)
Graham-Garcia J, Heath J and Andrews J (2005) Defibrillation and biphasic shocks: Implications for perianesthesia nursing. Journal of Perianesthesia Nursing 20(1), 23-34.
Hamilton R (2005) Nurses' knowledge and skill retention following cardiopulmonary resuscitation training: A review of the literature. Journal of Advanced Nursing 51(3), 288-297.
Inwood H (1995) Knowledge of resuscitation. Intensive and Critical Care Nursing 12, 33-39.
Kloeck W, Cummins R, Chamberkain D, Bossaert L, Christenson J and Sanders A (1997) Early defibrillation: An advisory statement from the Advanced Life Support Working Group of the International Liaison Committee on Resuscitation. Circulation 95(8), 2183-2184.
Madden C (2006) Undergraduate nursing students' acquisition and retention of CPR knowledge and skills. Nursing Education Today 26(3), 218-227.
Mancini ME and William K (1999) AEDs: Changing the way you respond to cardiac arrest. American Journal of Nursing 99(5), 26-31.
Marenco J, Wang P, Link. M, Homoud M and Estes NA (2001) Improving survival from sudden cardiac arrest: The role of the automated external defibrillator. Journal of the American Medical Association 285(9), 1193-1200.
Michael D (1999) An evaluative study of the basic life support skills of nurses in an independent hospital. Journal of Clinical Nursing 8(2), 201-205.
Nagashima K, Takahata O, Fujimoto K, Suzuki A and Iwasaki H (2003) Investigation on nurses' knowledge of and experience in cardiopulmonary resuscitation and on nurses' knowledge of the guidelines for cardiopulmonary resuscitation and emergency cardiovascular care established in 2000. Masui 52(4), 427-430.
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