Intensive Care Unit, United Christian Hospital, 130, Hip Wo Street, Kwun Tong, Hong Kong.
Intensive Crit Care Nurs. 2011 Aug;27(4):186-93. doi: 10.1016/j.iccn.2011.04.007. Epub 2011 Jun 8.
The study examines the experience of intensive care nurses in caring for patients in cardiac arrest, and their perceptions of introducing nurse-led defibrillation.
This was a descriptive, exploratory and qualitative study at an intensive care unit (ICU) of an acute regional hospital in Hong Kong. Twelve registered nurses were purposefully selected for interview.
Although all the participants were trained in basic life support, only 50% were trained in advanced cardiac life support (ACLS), and those trained in ACLS described having limited opportunities to apply their defibrillation knowledge. Whilst participants believed that they were theoretically prepared to influence the patient's resuscitation outcomes, newly qualified nurses were reluctant to be accountable for defibrillation. In contrast, experienced nurses were more willing to perform nurse-led defibrillation. Support from management, cooperation between nurses and doctors, regular in-hospital 'real-drill' programmes, sponsorship for training, and the use of alternative defibrillation equipment should be considered to encourage nurse-led defibrillation in ICU settings.
Nurse-led defibrillation is an approach of delivering prompt care to critically ill patients, and a way ahead for intensive care nursing in Hong Kong. Emphasis on a consistent policy to promote nurse-led defibrillation practice is needed.
本研究考察了重症监护病房护士在心脏骤停患者护理方面的经验，以及他们对引入护士主导除颤的看法。
这是一项在香港一家急性区域医院的重症监护病房（ICU）进行的描述性、探索性和定性研究。通过目的性抽样，选择了 12 名注册护士进行访谈。
尽管所有参与者都接受过基本生命支持培训，但只有 50%接受过高级心脏生命支持（ACLS）培训，而接受过 ACLS 培训的参与者表示，他们应用除颤知识的机会有限。虽然参与者认为他们在理论上有能力影响患者的复苏结果，但新入职的护士不愿意对除颤负责。相比之下，经验丰富的护士更愿意进行护士主导的除颤。应考虑为 ICU 环境中的护士主导除颤提供管理支持、护士与医生之间的合作、定期院内“实战演练”计划、培训赞助以及替代除颤设备的使用，以鼓励护士主导除颤。
护士主导的除颤是为危重症患者提供及时护理的一种方法，也是香港重症监护护理的未来方向。需要强调的是，要制定一致的政策来促进护士主导的除颤实践。
