Wynne Rochelle, Lodder Teresa, Trapani Tony, Hanlon Gabrielle, Cleary Carmel
School of Nursing, Deakin University, Melbourne, Vic.
Aust Crit Care. 2002 Aug;15(3):94-100. doi: 10.1016/s1036-7314(02)80049-2.
Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs, Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position. The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation. A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.
现行法律不允许具备适当资质的第1类注册护士（RN）在没有医疗人员在场的情况下给予一线复苏药物。1981年《毒品、毒物及受控物质法》（维多利亚州）和1995年《毒品、毒物及受控物质条例》（维多利亚州）的这一疏漏，使许多重症监护护士处于易受法律影响的境地。本研究的主要目的是评估重症监护护士对于游说修改现行法律的看法。此外，该研究旨在探讨和描述在重症监护领域工作的注册护士在没有医疗人员在场时进行心肺复苏和给予一线高级生命支持（ALS）药物方面的教育准备情况、实践认知和经验。预计收集到的数据将展示一些与重症监护护士实施和给予ALS药物相关的困境，并可用于为监管机构提供信息，以便他们了解重症监护护士在复苏过程中面临的问题。向澳大利亚重症监护护士学院（ACCCN）维多利亚州分会的所有成员发送了一份邮寄调查问卷。结果显示，大多数护士每年接受一次ALS评估且拥有当前的ALS认证。护士们表示，他们觉得自己在教育方面有所准备，并且有信心在没有医疗人员在场的情况下管理心肺复苏；事实上，大多数人都这样做过。还突出了大都市、地区和农村护士在实践问题上的差异。因此，有明确证据表明，鉴于心肺骤停的时间紧迫性，立法修订是适当且必要的。ACCCN维多利亚州有限公司游说维多利亚州政府修改法律得到了压倒性的支持。
