Brittan Browning1, Kent E Page, Renee L Kuhn, Mary Ann DiLiberto, Jendar Deschenes, Eileen Taillie, Elyse Tomanio, Richard Holubkov, J Michael Dean, Frank W Moler, Kathleen Meert, Victoria L Pemberton. 1. 1Office of the Senior Vice President, University of Utah, Salt Lake City, UT. 2Department of Pediatrics, University of Utah, Salt Lake City, UT. 3Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA. 4Department of Pediatrics, University of Arizona, Tucson, AZ. 5Department of Pediatrics, University of Rochester Medical Center/Golisano Children's Hospital, Rochester, NY. 6Department of Critical Care, Children's National Medical Center, Washington, DC. 7Department of Pediatrics, University of Michigan Ann Arbor, Ann Arbor, MI. 8Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI. 9The Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD.
Abstract
OBJECTIVES: To understand factors affecting nurses' attitudes toward the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials and association with approach/consent rates. DESIGN: Cross-sectional survey of pediatric/cardiac intensive care nurses' perceptions of the trials. SETTING: Study was conducted at 16 of 38 self-selected study sites. SUBJECTS: Pediatric and cardiac intensive care nurses. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the proportion of nurses with positive perceptions, as defined by agree or strongly agree with the statement "I am happy to take care of a Therapeutic Hypothermia after Pediatric Cardiac Arrest patient". Associations between perceptions and study approach/consent rates were also explored. Of 2,241 nurses invited, 1,387 (62%) completed the survey and 77% reported positive perceptions of the trials. Nurses, who felt positively about the scientific question, the study team, and training received, were more likely to have positive perceptions of the trials (p < 0.001). Nurses who had previously cared for a research patient had significantly more positive perceptions of Therapeutic Hypothermia After Pediatric Cardiac Arrest compared with those who had not (79% vs 54%; p < 0.001). Of the 754 nurses who cared for a Therapeutic Hypothermia After Pediatric Cardiac Arrest patient, 82% had positive perceptions, despite 86% reporting it required more work. Sixty-nine percent believed that hypothermia reduces brain injury and mortality; sites had lower consent rates when their nurses believed that hypothermia was beneficial. Institution-specific approach rates were positively correlated with nurses' perceptions of institutional support for the trial (r = 0.54; p = 0.04), ICU support (r = 0.61; p = 0.02), and the importance of conducting the trial in children (r = 0.61; p = 0.01). CONCLUSIONS: The majority of nurses had positive perceptions of the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials. Institutional, colleague, and study team support and training were contributing factors. Despite increased work, nurses remained enthusiastic demonstrating that studies with intensive bedside nursing procedures are feasible. Institutions whose nurses believed hypothermia was beneficial had lower consent rates, suggesting that educating nurses on study rationale and equipoise may enhance study participation.
OBJECTIVES: To understand factors affecting nurses' attitudes toward the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials and association with approach/consent rates. DESIGN: Cross-sectional survey of pediatric/cardiac intensive care nurses' perceptions of the trials. SETTING: Study was conducted at 16 of 38 self-selected study sites. SUBJECTS: Pediatric and cardiac intensive care nurses. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the proportion of nurses with positive perceptions, as defined by agree or strongly agree with the statement "I am happy to take care of a Therapeutic Hypothermia after Pediatric Cardiac Arrest patient". Associations between perceptions and study approach/consent rates were also explored. Of 2,241 nurses invited, 1,387 (62%) completed the survey and 77% reported positive perceptions of the trials. Nurses, who felt positively about the scientific question, the study team, and training received, were more likely to have positive perceptions of the trials (p < 0.001). Nurses who had previously cared for a research patient had significantly more positive perceptions of Therapeutic Hypothermia After Pediatric Cardiac Arrest compared with those who had not (79% vs 54%; p < 0.001). Of the 754 nurses who cared for a Therapeutic Hypothermia After Pediatric Cardiac Arrest patient, 82% had positive perceptions, despite 86% reporting it required more work. Sixty-nine percent believed that hypothermia reduces brain injury and mortality; sites had lower consent rates when their nurses believed that hypothermia was beneficial. Institution-specific approach rates were positively correlated with nurses' perceptions of institutional support for the trial (r = 0.54; p = 0.04), ICU support (r = 0.61; p = 0.02), and the importance of conducting the trial in children (r = 0.61; p = 0.01). CONCLUSIONS: The majority of nurses had positive perceptions of the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials. Institutional, colleague, and study team support and training were contributing factors. Despite increased work, nurses remained enthusiastic demonstrating that studies with intensive bedside nursing procedures are feasible. Institutions whose nurses believed hypothermia was beneficial had lower consent rates, suggesting that educating nurses on study rationale and equipoise may enhance study participation.
Authors: Stephanie Fuller; Ramakrishnan Rajagopalan; Gail P Jarvik; Marsha Gerdes; Judy Bernbaum; Gil Wernovsky; Robert R Clancy; Cynthia Solot; Susan C Nicolson; Thomas L Spray; J William Gaynor Journal: Ann Thorac Surg Date: 2010-12 Impact factor: 4.330
Authors: Denis V Azzopardi; Brenda Strohm; A David Edwards; Leigh Dyet; Henry L Halliday; Edmund Juszczak; Olga Kapellou; Malcolm Levene; Neil Marlow; Emma Porter; Marianne Thoresen; Andrew Whitelaw; Peter Brocklehurst Journal: N Engl J Med Date: 2009-10-01 Impact factor: 91.245