Critical care nurses' perceptions and attitudes towards training in adult resuscitation

Abstract

The purpose of this study was to explore critical care nurses’ knowledge and views towards resuscitation guidelines, their confidence and perceived competence when participating in resuscitation attempts, as well as perceptions and attitudes towards adults resuscitation training. A sequential-explanatory design was adopted to fulfil the aims and objectives of the study. This mixed-methods approach incorporated the use of a questionnaire to collect data on views and attitudes, followed by a focus group interview to achieve deeper exploration of issues identified through the questionnaires .This enhance the interpretation of findings and allowed a more realistic description of the situation under study.

Data collection was conducted within the four critical care settings at Mater Dei Hospital; namely the accident and emergency, the intensive care unit, critical cardiac care units and the anaesthesia department. All the nurses within this population (n= 222) were recruited to participate in the first part of the study (qualitative phrase), however, nurses representing cardiac care units did not participate in the focus group interview.

Findings revealed that critical care nurses have a positive perception of their resuscitation situations. While guidelines are considered as somewhat significant in guiding resuscitation situations, knowledge of these guidelines is not as high as required from health care professionals. The importance of initial and refresher training was highlighted, however there are several barriers which hinder nurses from attending to such training. Current courses do not effectively prepare nurses to fulfil the demands imposed on them by their settings. Furthermore, while training in skills supportive to basic life support could help enhance performance during cardiac arrest situations, courses need to be designed in accordance with the expected role of the nurse within each specific setting. Issues of mandatory resuscitation training have also been highlighted throughout the findings, and the combination of formal and informal sessions was identified as a possible approach to ensure that the required level of skill and knowledge is reached, while ensuring that specific requirements for each setting are also addressed.

Regular audits to identify and address deficiencies and inaccuracies in knowledge and skill are recommended to ensure the best possible performance during cardiac arrest situations. Furthermore, a needs assessment is recommended to identify the learning content for resuscitation courses to address nurses’ needs during resuscitation situations within their settings. Further research on variables within resuscitation training, such as confidence, competence, previous training, experience, exposure and work setting, are also recommended to highlight the dynamics within nurses’ perceptions and attitudes towards training.