A comparison of Australian and American registered nurses' use of life-sustaining medical devices in critical care and high-dependency units.

OBJECTIVE

To explore how and what Australian and American registered nurses working in critical care and high-dependency units initially learn about the life-sustaining medical devices they use as well as the consequences of device use both for patients and staff.

DESIGN

Cross-sectional survey with a mailed questionnaire.

SETTING

Large midwestern American tertiary care center and two large South Australian tertiary care centers.

SUBJECTS

Thirty-two American registered nurses who worked in critical care and 127 Australian registered nurses who worked in critical care, coronary care, and high-dependency units.

RESULTS

The most frequently identified initial method of learning both for Australian and American registered nurses was trial and error (taught self). A significantly larger proportion of American nurses initially learned to use a life-sustaining device by watching a video or slide tape, whereas a significantly larger proportion of Australian nurses received instruction in nursing school. At least 90% of Australian and American nurses indicated they initially had learned the same four facts about the device: its purpose, its function, how to respond to the alarms, and how to operate it. A significantly larger proportion of Australian nurses indicated that they had learned about the potential hazards for patients than did their American colleagues. The potential consequences of using any medical device were nurse stress and patient harm. The two reasons most frequently cited by Australian and American nurses for stress were fear of harming the patient and being unsure how to use the device. Of the Australian and American nurses combined, 12.3% indicated they had used a medical device that had harmed a patient.

CONCLUSIONS

Australian and American registered nurses were more similar than dissimilar in terms of how and what they learned about the life-sustaining devices they use in direct patient care, in experiencing stress when using medical devices, and in having used a device that caused patient harm. Differences in how they learn may be a reflection of marketing and inservice support by manufacturers and basic and highest levels of nurse education. The latter may also account for differences in what Australian and American nurses learned. The results emphasize that nurses must be knowledgeable about the devices they use on behalf of patients. More knowledge about the devices they use in direct patient care might decrease nurse stress.