Hsing-Lin Lin a, b, c, f, Wei-Che Lee a, b, c, Meng-Ting Huang d, Wen-Hui Hsiao d, Liang-Chi Kuo a, b, Hon-Man Chan a, b, c, Jiun-Nong Lin e, Yu-Hsien Chuang d, f
aDivision of Trauma, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
bDepartment of Emergency Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
cDepartment of Surgery, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
dDepartment of nursing, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
eDivision of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
fQraduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan
Head nurses in a hospital setting work to maintain the quality of nursing care and ensure that staff nursing skills are up-to-date. Although cardiopulmonary resuscitation (CFR) is most often performed by physicians in a hospital, nurses play crucial assistance roles, including the administration of medication, record-keeping, obtaining intravenous access, and helping with intubation. Patient outcome is therefore related to nurses' skill level in CFR. We hypothesized that the more senior head nurses would be more skillful at assisting with CFR.
Materials and Methods
We conducted an observational study of 55 head nurses, who were asked to perform a 4-minute simulation in which they assisted with CFR using a resuscitation manikin. We collected demographic data, including age and years since becoming a nurse and becoming a head nurse, together with a stress score, which assessed the stress felt by the nurses while taking the test. These measures were analyzed along with the accuracy of the nurses' skills while performing CFR.
Twenty-two skills were evaluated, with each skill graded as either a pass or fail. Only 30/55 (54.5%) of the head nurses passed all 22 skills. There was a significant difference in the numbers of skills with a pass rating (p = 0.043) in relation to the units where the head nurses were employed. Their performance also showed a strong negative correlation with age (p = 0.001), work experience (p = 0.028), and time since becoming head nurse (p<0.001). However, there was no significant difference between the numbers of skills with a pass rating and pre-test stress score (p = 0.129).
In our study, the head nurses of surgical wards, medical wards, and intensive care units had better scores than the head nurses of pediatric, obstetrics-gynecology, and other units. In contrast with our original hypothesis, we found that the more senior head nurses' skills when assisting with CFR were poorer than those of their more junior colleagues. This suggests that senior head nurses should undergo frequent refresher courses, not only to help maintain their life-saving abilities, but also so that they can better mentor less experienced nurses in situations requiring CFR.
Cardiopulmonary resuscitation; Education; Head nurse