Towards better out-of-hospital cardiopulmonary resuscitation: A survey of nurses.

OBJECTIVES

To examine the knowledge, attitude and practice of nurses in Lebanon regarding out-of-hospital resuscitation, compare hospital nurses to those who work in community settings on the variables of interest, determine the nurses' willingness to attempt resuscitation in the community and identify predictors of their willingness.

BACKGROUND

Only 5.5% of victims survive out-of-hospital cardiac arrest in Lebanon. There is no national guideline for cardiopulmonary resuscitation nor a policy for nurses' training in resuscitation in Lebanon for neither in-hospital nor out-of-hospital settings. However, some hospitals have their own policies.

METHODS

A cross-sectional descriptive design was used with a cluster sample of 692 working nurses. A 28-item questionnaire developed for this study was mailed to the nurses. Data were analysed with correlational and multivariable regression analyses. The STROBE checklist for observational studies was used in reporting this study.

RESULTS

Most nurses received cardiopulmonary resuscitation training, but 19.8% did not renew their certification in the past two years, because of limited training centres and lack of time. Only one third of the sample knew the first step to be taken in an arrest, yet 61% knew the compression-to-breath ratio. Nurses who work in community settings had significantly less frequent training in resuscitation than hospital nurses. Most nurses were willing to resuscitate in the community. In deciding to perform out-of-hospital cardiopulmonary resuscitation, the nurses were mostly influenced by their training, courage, recent practice, policy, fear of infection and hesitation to do mouth-to-mouth breathing. Receiving training, fear of being sued, religious beliefs, geographic location and believing in the importance of training laypeople in resuscitation predicted the nurses' willingness to perform resuscitation in the community.

CONCLUSION

Lebanon needs a national policy on cardiopulmonary resuscitation, regular training of all nurses and a Good Samaritan law.

RELEVANCE TO CLINICAL PRACTICE

This study informs policy related to nurses' training in out-of-hospital resuscitation.