Need for advanced cardiac life-support training in rural, community hospitals.
Crit Care Med
; 22(5): 735-40, 1994 May.
Article
em En
| MEDLINE
| ID: mdl-8181280
ABSTRACT
OBJECTIVE:
To define the relative needs of the staffs of rural, community hospitals for training in advanced cardiac life support (ACLS), identify weaknesses, and modify a standard ACLS course to meet these needs.DESIGN:
Prospective assessment of knowledge and skills relating to the practice of ACLS.SETTING:
Rural, community hospitals in southern Wisconsin.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
A well-validated, multiple-option, precourse test for life-support knowledge and clinical judgment was administered to the staff nurses, respiratory therapists, and practicing physicians of 12 rural, community hospitals in southern Wisconsin before their participation in a modified, extended, ACLS course, using the pre-1992 American Heart Association standards and guidelines. Testing was accomplished over 4 yrs. Detailed item analysis of the test was performed. A total of 461 persons participated. Overall, physicians performed better (p < .001) than did the nurses. Precourse difficulties included electrocardiographic rhythm strip interpretation, particularly with identification of the atrioventricular (A-V) blocks. Only 39.6% of the nurses and 64.1% of the physicians correctly identified third-degree A-V block. One third of the nurses and 22% of the physicians did not correctly identify coarse ventricular fibrillation. The pharmacologic properties and utility of atropine and epinephrine were not understood. Propranolol was selected for treatment of third-degree A-V block by 31.6% and 22.8% of the nurses and the physicians, respectively. Neither group was able to accurately distinguish between the components of disturbances in acid-base balance. The esophageal obturator airway tube was not a familiar tool to any of the groups. No improvement in overall performance on pretests occurred across the calendar years of the study.CONCLUSIONS:
There is a need for ACLS training in community hospitals. Educational programs for physicians and staffs should be designed to meet that need.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Recursos Humanos em Hospital
/
Saúde da População Rural
/
Isquemia Miocárdica
/
Necessidades e Demandas de Serviços de Saúde
/
Hospitais Comunitários
/
Cuidados para Prolongar a Vida
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
1994
Tipo de documento:
Article