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Original Article
- Nurses’ Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest
- Eun Jung Kim1, Kyeong Ryong Lee2, Myung Hyun Lee3, Jiyoung Kim4
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Journal of Korean Academy of Nursing 2012;42(3):361-368.
DOI: https://doi.org/10.4040/jkan.2012.42.3.361
Published online: June 12, 2012
1Full-time Lecturer, College of Nursing, Eulji University, Seongnam, Korea
2Associate Professor, Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
3CPR Education Center, Konkuk University Medical Center, Seoul, Korea
4Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
1Full-time Lecturer, College of Nursing, Eulji University, Seongnam, Korea
2Associate Professor, Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
3CPR Education Center, Konkuk University Medical Center, Seoul, Korea
4Assistant Professor, Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
- Address reprint requests to : Lee, Kyeong Ryong Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120 Neundong-ro, Gwangjin-gu, Seoul 143-729, Korea Tel: +82-2-2030-5791 Fax: +82-2-2030-5789 E-mail: lkrer@kuh.ac.kr
• Received: May 11, 2011 • Revised: May 18, 2011 • Accepted: May 28, 2012
Copyright © 2012 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose
- The purpose of this study was to analyze the cardiopulmonary resuscitation skills and teamwork of nurses in simulated cardiac arrests in the hospital.
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Methods
- A descriptive study was conducted with 35 teams of 3 to 4 registered nurses each in a university hospital located in Seoul. A mannequin simulator was used to enact simulated cardiac arrest. Assessment included critical actions, time elapsed to initiation of critical actions, quality of cardiac compression, and teamwork which comprised leadership behavior and communication among team members.
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Results
- Among the 35 teams, 54% recognized apnea, 43% determined pulselessness. Eighty percent of the teams compressed at an average elapsed time of 108 ± 75 seconds with 35%, 36%, and 67% mean rates of correct compression depth, rate, and placement, respectively. Thirty- seven percent of the teams defibrillated at 224± 67 seconds. Leadership behavior and communication among team members were absent in 63% and 69% of the teams, respectively.
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Conclusion
- The skills of the nurses in this study cannot be considered adequate in terms of appropriate and timely actions required for resuscitation. Future resuscitation education should focus on improving the quality of cardiopulmonary resuscitation including team performance targeting the first responders of cardiac arrest.
Table 1.General Characteristics of Participants (N=115)
Table 2.Nurses’ Critical Actions during 5 minutes Simulated Cardiac Arrest (N=35)
Table 3.Quality of Chest Compressions during 5 minutes Simulated Cardiac Arrest (N=28)
Table 4.Teamwork Rating during 5 minutes Simulated Cardiac Arrest (N=35)
| Variables | Categories | n (%) |
|---|---|---|
| Leadership behavior | Not at all | 22 (62.9) |
| Somewhat | 9 (25.7) | |
| Adequate | 4 (11.4) | |
| Communication | Not at all | 24 (68.6) |
| Somewhat | 7 (20.0) | |
| Adequate | 4 (11.4) |
- Abella B. S., Alvarado J. P., Myklebust H., Edelson D. P., Barry A., O'Hearn N., et al. 2005;Quality of cardiopulmonary resuscitation during in- hospital cardiac arrest. The Journal of the American Medical Association. 293:305–310. http://dx.doi.org/10.1001/jama.293.3.305ArticlePubMed
- American Heart Association. 2006.Basic life support for healthcare providers. Dallas, TX: Author.
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Nurses’ Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest
| Characteristics | Categories | n (%) |
|---|---|---|
| Gender | Male | 3 (2.6) |
| Female | 112 (97.4) | |
| Age (yr) | ≤25 | 33 (28.7) |
| 26-30 | 52 (45.2) | |
| 31-35 | 27 (23.5) | |
| 36-40 | 1 (0.9) | |
| >40 | 2 (1.7) | |
| Education | Associate degree | 23 (20.0) |
| Bachelor degree | 82 (71.3) | |
| ≥Master | 10 (8.7) | |
| Working experience (yr) | <1 | 21 (18.6) |
| 1-2 | 20 (17.7) | |
| 3-4 | 25 (22.1) | |
| 5-7 | 26 (23.0) | |
| ≥8 | 21 (18.6) | |
| Working experience in ICU/ER | No | 101 (87.8) |
| Yes | 14 (12.2) | |
| Experience in CPR | No | 50 (43.5) |
| Yes | 65 (56.5) | |
| Experience in any CPR education | No | 1 (0.9) |
| Yes | 114 (99.1) | |
| Latest CPR education (months ago) | ≤3 | 25 (23.1) |
| 4-6 | 48 (44.4) | |
| 7-12 | 33 (30.6) | |
| 13-18 | 1 (0.9) | |
| >18 | 1 (0.9) |
| Variables | Critical action completion n (%) | Time to completion (seconds) M±SD or Median (IQR) |
|---|---|---|
| Recognize unresponsiveness | 33 (94.3) | 5.0 (4-10) |
| Call for help | 31 (88.6) | 13.0 (8-31) |
| Recognize apnea | 19 (54.3) | 32.5±34.8 |
| Recognize pulselessness | 15 (42.9) | 35.3±32.0 |
| Initiate chest compression | 28 (80.0) | 107.8±75.3 |
| Initiate BVM ventilation | 30 (85.7) | 162.1±63.0 |
| Recognize ECG rhythm | 17(48.6) | 165.9±68.2 |
| Apply appropriate defibrillation | 13 (37.1) | 224.0±66.8 |
| Variables | M±SD |
|---|---|
| Total time of compression during 5 minutes (seconds) | 133.0±65.2 |
| Mean rate of correct compression depth (%) | 34.8±24.8 |
| Mean rate of correct compression rate (%) | 36.1±28.8 |
| Mean rate of correct placement of hands (%) | 66.6±28.0 |
| Variables | Categories | n (%) |
|---|---|---|
| Leadership behavior | Not at all | 22 (62.9) |
| Somewhat | 9 (25.7) | |
| Adequate | 4 (11.4) | |
| Communication | Not at all | 24 (68.6) |
| Somewhat | 7 (20.0) | |
| Adequate | 4 (11.4) |
Table 1. General Characteristics of Participants (N=115)
ICU=Intensive care unit; ER=Emergency room; CPR=Cardiopulmonary resuscitation.
Table 2. Nurses’ Critical Actions during 5 minutes Simulated Cardiac Arrest (N=35)
IQR=Interquartile range; BVM=Bag valve mask; ECG=Electrocardiography.
Table 3. Quality of Chest Compressions during 5 minutes Simulated Cardiac Arrest (N=28)
Table 4. Teamwork Rating during 5 minutes Simulated Cardiac Arrest (N=35)
