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急诊科心肺复苏团队成功的障碍:护士的视角

Barriers to the success of cardiopulmonary resuscitation teams in emergency departments: A perspective from nurses.

作者信息

Sadeghi Alireza, Jahani Hosein, Senmar Mojtaba, Mehdipour Farzaneh, Mirzaei Amir Reza, Poorshivaee Ali, Hosseini Faranak Sadat

机构信息

Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.

Student Research Committee, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

出版信息

BMC Emerg Med. 2025 May 30;25(1):85. doi: 10.1186/s12873-025-01245-5.

Abstract

BACKGROUND

Cardiopulmonary arrest is one of the most important emergency situations in hospitals. Although cardiopulmonary resuscitation has long been the first step in these conditions, the low success rate of this process is still a major concern in treatment systems. Therefore, identifying the barriers and causes of failure of the cardiopulmonary resuscitation team has become an important factor in improving the results. The present study was conducted to identify the barriers to the success of cardiopulmonary resuscitation teams in emergency departments.

METHODS

A descriptive-analytical study was conducted in the emergency department of teaching hospitals in Qazvin, Iran 2023-2024. Using available sampling, 198 emergency department nurses were included in the study. Nurses were included in the study if they had at least 6 months of work experience in the emergency department, had at least a bachelor's degree, and experienced at least one cardiopulmonary resuscitation operation. The exclusion criteria were incomplete completion of the questionnaires and withdrawal from the study for any reason. The data was collected using the demographic characteristics checklist and the questionnaire on barriers to the success of the cardiopulmonary resuscitation team. Data analysis was performed using SPSS-24 software and descriptive and inferential statistics. The significance level of all tests was considered less than p < 0.05.

RESULTS

The mean age of the participants was 30.96 ± 5.15. Out of 198 nurses participating in the study, 125 were female (63.1%) and the rest were male. According to the results, the main barriers to the success of the cardiopulmonary resuscitation team in the emergency department are related to the individual and professional characteristics of the resuscitation team members with a score of 2.50 ± 0.38 and the least reason is related to the program and educational facilities dimension with a score of 2.32 ± 0.50. In the patient characteristics dimension, the initial rhythm (2.70 ± 0.58) and in the individual and professional characteristics of the resuscitation team members, the lack of skilled and experienced people (2.62 ± 1.51) were the main barriers to the success of the cardiopulmonary resuscitation team. From the nurses' point of view, in the dimension of resuscitation team management, the absence of an effective leader in the team (2.41 ± 0.64), in the dimension of equipment and devices needed for resuscitation, the absence and unpreparedness of resuscitation equipment and devices in the department (2.53 ± 0.55), and in the dimension of program and educational facilities related to resuscitation, the lack of adequate and appropriate educational facilities and equipment (2.40 ± 0.64) were the main barriers to the success of the cardiopulmonary resuscitation team. The results of the t-test showed that there is no significant relationship between age, gender, and educational qualification with the average score of the whole questionnaire (P > 0.05).

CONCLUSIONS

The results of this study showed that the individual and professional characteristics of cardiopulmonary resuscitation team members are the weak points and the most important barriers to the success of this team in the emergency department. Therefore, it is possible to reduce the barriers to the success of cardiopulmonary resuscitation and increase the survival rate of cardiopulmonary resuscitation by using experienced, skilled, and highly knowledgeable staff. Reducing or eliminating these barriers requires a detailed policy of managers and planners in individual, equipment, and training dimensions.

摘要

背景

心肺骤停是医院中最重要的紧急情况之一。尽管长期以来心肺复苏一直是应对这些情况的首要步骤,但该过程的低成功率仍是治疗系统中的一个主要问题。因此,识别心肺复苏团队失败的障碍和原因已成为改善结果的一个重要因素。本研究旨在确定急诊科心肺复苏团队成功的障碍。

方法

2023年至2024年在伊朗加兹温教学医院急诊科进行了一项描述性分析研究。采用便利抽样法,198名急诊科护士纳入研究。纳入标准为在急诊科至少有6个月工作经验、至少拥有学士学位且经历过至少一次心肺复苏操作。排除标准为问卷填写不完整以及因任何原因退出研究。通过人口统计学特征清单和心肺复苏团队成功障碍问卷收集数据。使用SPSS-24软件进行数据分析,并采用描述性和推断性统计。所有检验的显著性水平设定为p < 0.05。

结果

参与者的平均年龄为30.96 ± 5.15岁。参与研究的198名护士中,125名是女性(63.1%),其余为男性。结果显示,急诊科心肺复苏团队成功的主要障碍与复苏团队成员的个人和专业特征相关,得分为2.50 ± 0.38,而与项目和教育设施维度相关的原因最少,得分为2.32 ± 0.50。在患者特征维度中,初始心律(2.70 ± 0.58)以及在复苏团队成员的个人和专业特征方面,缺乏熟练和有经验的人员(2.62 ± 1.51)是心肺复苏团队成功的主要障碍。从护士的角度来看,在复苏团队管理维度中,团队中缺乏有效的领导者(2.41 ± 0.64),在复苏所需的设备和器械维度中,科室中复苏设备和器械的缺失及未准备好(2.53 ± 0.55),以及在与复苏相关的项目和教育设施维度中,缺乏足够和合适的教育设施和设备(2.40 ± 0.64)是心肺复苏团队成功的主要障碍。t检验结果显示,年龄、性别和学历与整个问卷的平均分之间无显著关系(P > 0.05)。

结论

本研究结果表明,心肺复苏团队成员的个人和专业特征是该团队在急诊科成功的薄弱环节和最重要障碍。因此,通过使用经验丰富、技能娴熟且知识渊博的工作人员,有可能减少心肺复苏成功的障碍并提高心肺复苏的存活率。减少或消除这些障碍需要管理人员和规划人员在个人、设备和培训维度制定详细政策。

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