Korean J Adult Nurs.  2017 Oct;29(5):484-495. 10.7475/kjan.2017.29.5.484.

Attitudes and Type Analysis of Cardiopulmonary Resuscitation among Hospital Nurses in Emergency Room and Intensive Care Units

• Ha EH
• Hyun KS

• KMID: 2406518
• DOI: http://doi.org/10.7475/kjan.2017.29.5.484

Abstract

PURPOSE
Subjective Attitudes toward cardiopulmonary resuscitation (CPR) can be diverse. The purpose of this study was to identify subjective attitudes toward CPR among hospital nurses working in emergency room and intensive care units.
METHODS
The Q methodology was used. The 42 Q-statements selected by each of the 38 participants were classified into a shape of normal distribution. The collected data were analyzed using a QUANL program.
RESULTS
Three types of attitudes emerged: "˜TypeI, CPR requires professionalism(medical personnel-centered)', "˜Type II, CPR requires reality (patient-centered)', and "˜Type III, CPR requires ethicality (human dignity-centered)'.
CONCLUSION
The findings suggest that nursing intervention programs for the three types should be developed. Mandatory repeat education programs for TypeI, Development of guidelines for the prohibition and termination of CPR for TypeII. Continuing education on wills and advance directives for TypeIII can be helpful.

MeSH Terms

Advance Directives
Cardiopulmonary Resuscitation*
Critical Care*
Education
Education, Continuing
Emergencies*
Emergency Service, Hospital*
Intensive Care Units*
Nursing

Figure

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  Figure 1. Sample of completed Q-Sort table.

Reference

1. Yuksen C, Sawatmongkornkul S, Tuangsirisup J, Sawanyawi-suth K, Sittichanbuncha Y. The CPR outcomes of online medical video instruction versus on-scene medical instruction using simulated cardiac arrest stations. BMC Emergency Medicine. 2016; 16(1):25. https://doi.org/10.1186/s12873-016-0092-3.

2. Vural M, Koş ar MF, Kerimoğ lu O, Kı zkapan F, Kahyaoğ lu S, Tuğ rul S, et al. Cardiopulmonary resuscitation knowledge among nursing students: a questionnaire study. Anatolian Journal of Cardiology. 2017; 17(2):140–5. https://doi.org/10.14744/AnatolJCardiol.2016.7156.

3. van de Glind EM, van Munster BC, van de Wetering FT, van Delden JJ, Scholten RJ, Hooft L. Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review. BMC Geriatrics. 2013; 13:68. https://doi.org/10.1186/1471-2318-13-68.

4. Fallahi M, Banaderakhshan H, Abdi A, Borhani F, Kaviannez-had R, Karimpour HA. The Iranian physicians attitude toward the do not resuscitate order. Journal of Multidisciplinary Healthcare. 2016; 9:279–84. https://doi.org/10.2147/JMDH.S105002.

5. Kumari KM, Amberkar MB, Alur SS, Bhat PM, Bansal S. Clinical awareness of do's and don'ts of cardiopulmonary resuscitation (CPR) among university medical students-A questionnaire study. Journal of Clinical and Diagnostic Research. 2014; 8(7):MC08–11. https://doi.org/10.7860/JCDR/2014/8541.4567.

6. Saramma PP, Raj LS, Dash PK, Sarma PS. Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses. Indian Journal of Critical Care Medicine. 2016; 20(4):226–32. https://doi.org/10.4103/0972-5229.180043.

7. Clarke S, Carolina Apesoa-Varano E, Barton J. Code Blue: methodology for a qualitative study of teamwork during simulated cardiac arrest. BMJ Open. 2016; 6(1):e009259. https://doi.org/10.1136/bmjopen-2015-009259.

8. Toubasi S, Alosta MR, Darawad MW, Demeh W. Impact of simulation training on Jordanian nurses' performance of basic life support skills: a pilot study. Nurse Education Today. 2015; 35(9):999–1003. https://doi.org/10.1016/j.nedt.2015.03.017.

9. Zimmerman E, Cohen N, Maniaci V, Pena B, Lozano JM, Lina-res M. Use of a metronome in cardiopulmonary resuscitation: a simulation study. Pediatrics. 2015; 136(5):905–11. https://doi.org/10.1542/peds.2015-1858.

10. Sulzgruber P, Sterz F, Poppe M, Schober A, Lobmeyr E, Datler P, et al. Age-specific prognostication after out-of-hospital cardiac arrest-The ethical dilemma between ‘ life-sustaining treatment' and ‘ the right to die' in the elderly. European Heart Journal: Acute Cardiovascular Care. 2017; 6(2):112–20. https://doi.org/10.1177/2048872616672076.

11. Oliver D. David Oliver: resuscitation orders and reality. BMJ. 2016; 352:i1494. https://doi.org/10.1136/bmj.i1494.

12. Jeong SY, Kim CW, Yoon TH, Kim YJ, Hong SO, Choi JA. The factors influencing neurological outcome of out-of hospital cardiac arrest with cardiac etiology. Journal of the Korean Society of Emergency Medicine. 2016; 27(2):165–72.

13. Citolino Filho CM, Santos ES, Silva RDCG, Nogueira LDS. Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses. Revista da Escola de En-fermagem da USP. 2015; 49(6):907–13. https://doi.org/10.1590/S0080-623420150000600005.

14. Kim EJ, Lee KR. Relationship between non-technical skills and resuscitation performance of nurses' team in in-situ simulated cardiac arrest. Korean Journal of Adult Nursing. 2015; 27(2):146–55. https://doi.org/10.7475/kjan.2015.27.2.146.

15. Hwang SH. Knowledge, attitude, confidence, and experience of community health practitioner regarding cardiopulmonary resuscitation. The Korean Journal of Emergency Medical Services. 2014; 18(1):55–66. https://doi.org/10.14408/KJEMS.2014.18.1.055.

16. Mentzelopoulos SD, Bossaert L, Raffay V, Askitopoulou H, Perkins GD, Grief R. et al. A survey of key opinion leaders on ethical resuscitation practices in 31 European countries. Resuscitation. 2016; 100:11–7. https://doi.org/10.1016/j.resuscitation.2015.12.010.

17. Akhtar-Danesh N, Baumann A, Cordingley L. Q-methodolo-gy in nursing research: a promising method for the study of subjectivity. Western Journal of Nursing Research. 2008; 30(6):759–73. https://doi.org/10.1177/0193945907312979.

18. Kim HK. Q Methodology: philosophy, theories, analysis, and application. Seoul: Communication Books;2008.

19. Sjöberg F, Schönning E, Salzmann-Erikson M. Nurses' experiences of performing cardiopulmonary resuscitation in intensive care units: a qualitative study. Journal of Clinical Nursing. 2015; 24(17-18):2522–8. https://doi.org/10.1111/jocn.12844.

20. Wang C, Huang CC, Lin SJ, Chen JW. Using multimedia tools and high-fidelity simulations to improve medical students' resuscitation performance: an observational study. BMJ Open. 2016; 6(9):e012195. https://doi.org/10.1136/bmjopen-2016-012195.

21. Sahin KE, Ozdinc OZ, Yoldas S, Goktay A, Dorak S. Code Blue evaluation in children's hospital. World Journal of Emergency Medicine. 2016; 7(3):208–12. https://doi.org/10.5847/wjem.j.1920-8642.2016.03.008.

22. Spence AD, Derbyshire S, Walsh IK, Murray JM. Does video feedback analysis improve CPR performance in phase 5 medical students? BMC Medical Education. 2016; 16(1):203. https://doi.org/10.1186/s12909-016-0726-x.

23. Jeon HJ, Lee IS, Kim SC. Comparison of manual CPR versus X-CPRTM during simulative out of hospital. Korean Journal of Society for Wellness. 2015; 10(2):181–9.

24. Riggs KR, Becker LB, Sugarman J. Ethics in the use of extra-corporeal cardiopulmonary resuscitation in adults. Resuscitation. 2015; 91:73–5. https://doi.org/10.1016/j.resuscitation.2015.03.021.

25. Brummell SP, Seymour J, Higginbottom G. Cardiopulmonary resuscitation decisions in the emergency department: an ethnography of tacit knowledge in practice. Social Science & Medicine. 2016; 156:47–54. https://doi.org/10.1016/j.socscimed.2016.03.022.

26. Yi MS, Oh SE, Choi EO, Kwon IG, Kwon SB, Cho KM, et al. Hospital nurses experience of do-not resuscitate in Korea. Journal of Korean Academy of Nursing. 2008; 38(2):298–309. https://doi.org/10.4040/jkan.2008.38.2.298.

27. Woo MK, Kim MY. Nurses' experiences of do-not-resuscitate (DNR) by the narrative inquiry. Korean Journal of Adult Nursing. 2013; 25(3):322–31. https://doi.org/10.7475/kjan.2013.25.3.322.

28. Cho JL, Lee EN, Sim SH, Lee NY. Comparison of physicians and nurses' attitudes toward family presence during cardiopulmonary resuscitation. Korean Journal of Adult Nursing. 2013; 25(1):41–52. https://doi.org/10.7475/kjan.2013.25.1.41.

29. Chan WL. The " do-not-resuscitate" order in palliative surgery: ethical issues and a review on policy in Hong Kong. Palliative & Supportive Care. 2015; 13(5):1489–93. https://doi.org/10.1017/S1478951514001370.