Literature DB >> 16113181

To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership.

P Gilligan1, C Bhatarcharjee, G Knight, M Smith, D Hegarty, A Shenton, F Todd, P Bradley.   

Abstract

BACKGROUND AND OBJECTIVES: In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation.
METHODS: A prospective study was conducted at five emergency departments and one nurses' association meeting. All participants went through the same scenario. Details recorded included baseline blood pressure and pulse rate, time in post, time of ALS training, and subjective stress score (1 = hardly stressed; 10 = extremely stressed). Scoring took into account scenario understanding, rhythm recognition, time to defibrillation, appropriateness of interventions, and theoretical knowledge.
RESULTS: Of 57 participants, 20 were ALS trained nurses, 19 were ALS trained emergency senior house officers (SHOs), and 18 were emergency SHOs without formal ALS training. The overall mean score for doctors without ALS training was 69.5%, compared with 72.3% for ALS trained doctors and 73.7% for ALS trained nurses. Nurses found the experience less stressful (subjective stress score 5.78/10) compared with doctors without ALS training (6.5/10). The mean time taken to defibrillate from the appearance of a shockable rhythm on the monitor by the nurses and those SHOs without ALS training was 42 and 40.8 seconds, respectively.
CONCLUSION: ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs.

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Year:  2005        PMID: 16113181      PMCID: PMC1726914          DOI: 10.1136/emj.2004.015321

Source DB:  PubMed          Journal:  Emerg Med J        ISSN: 1472-0205            Impact factor:   2.740


  10 in total

1.  Leadership of resuscitation teams: "Lighthouse Leadership'.

Authors:  S Cooper; A Wakelam
Journal:  Resuscitation       Date:  1999-09       Impact factor: 5.262

2.  The nurse as team leader during advanced life support in A&E.

Authors:  S Gibson
Journal:  Emerg Nurse       Date:  1998-06

3.  Advanced life support skills undertaken by nurses--UK survey.

Authors:  F O'Higgins; M Ward; J Nolan
Journal:  Resuscitation       Date:  2001-07       Impact factor: 5.262

4.  Advanced life support: role of the rural registered nurse.

Authors:  J Jones; T Cooke
Journal:  Aust J Rural Health       Date:  1996-05       Impact factor: 1.662

Review 5.  The role of nurses in cardiopulmonary resuscitation and defibrillation.

Authors:  J Finn
Journal:  Collegian       Date:  1996-07       Impact factor: 2.573

6.  Advanced cardiac life support: a survey of interprofessional attitudes.

Authors:  R W Swanson; V R Ramsden
Journal:  Heart Lung       Date:  1988-05       Impact factor: 2.210

7.  A strategy for nurse defibrillation in general wards.

Authors:  E M Coady
Journal:  Resuscitation       Date:  1999-11       Impact factor: 5.262

8.  In-hospital resuscitation: association between ACLS training and survival to discharge.

Authors:  F C Dane; K S Russell-Lindgren; D C Parish; M D Durham; T D Brown
Journal:  Resuscitation       Date:  2000-09       Impact factor: 5.262

9.  Use of the Mega Code to evaluate team leader performance during advanced cardiac life support.

Authors:  W Kaye; M E Mancini
Journal:  Crit Care Med       Date:  1986-02       Impact factor: 7.598

10.  Knowledge and attitude of nurses on medical wards to defibrillation.

Authors:  A J Stewart; M D Lowe
Journal:  J R Coll Physicians Lond       Date:  1994 Sep-Oct
  10 in total
  5 in total

1.  Human factors in resuscitation: Lessons learned from simulator studies.

Authors:  S Hunziker; F Tschan; N K Semmer; M D Howell; S Marsch
Journal:  J Emerg Trauma Shock       Date:  2010-10

2.  Cardiopulmonary resuscitation, chest compression only and teamwork from the perspective of medical doctors, surgeons and anesthesiologists.

Authors:  Irena Krajina; Slavica Kvolik; Robert Steiner; Kristina Kovacevic; Ivan Lovric
Journal:  Iran Red Crescent Med J       Date:  2015-03-20       Impact factor: 0.611

3.  Exploring intensive care nurses' team performance in a simulation-based emergency situation, - expert raters' assessments versus self-assessments: an explorative study.

Authors:  Randi Ballangrud; Mona Persenius; Birgitta Hedelin; Marie Louise Hall-Lord
Journal:  BMC Nurs       Date:  2014-12-17

4.  Implications of long-term low-fidelity in situ simulation in acute care and association with a reduction in unexpected cardiac arrests: A retrospective research study.

Authors:  Chih Jung Wang; Su Yueh Lin; Sheng Han Tsai; Yan Shen Shan
Journal:  PLoS One       Date:  2019-03-12       Impact factor: 3.240

5.  Findings from a tandem clinician leadership intervention for emergency department cardiac arrest care during the COVID-19 pandemic.

Authors:  Harman S Gill; Phuong H Nguyen; Kayla A Fay; Frank DelGaudio; Matthew Roginski; Patricia Ruth Atchinson; Evie Marcolini
Journal:  Am J Emerg Med       Date:  2021-10-24       Impact factor: 4.093

  5 in total

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