Perceptions among nurses and physicians regarding enablers and barriers to effectiveness in the retention of cardiac life support skills

• Main Author: Garabedian, Carole Francis Daly
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2001
• Subjects: Adult education; Continuing education; Health education
• ISBN: 9780493255538; 0493255532

Patients in acute care settings fully expect that they will be resuscitated if they have a cardiac arrest. It is therefore necessary for nurses and physicians to receive basic and advanced cardiac life support education. Since life threatening events, such as cardiac arrest, must be responded to within six minutes, the retention of skills becomes a key concern in all acute care settings. This study focused on describing how nurses and physicians in a large urban medical center perceived the enablers and barriers to retaining cardiac life support skills. Four data instruments were used during this study: (a) the Basic Cardiac Life Support (BCLS) examination, (b) the Advanced Cardiac Life Support (ACLS) examination, (c) a demographic form, and (d) the Garabedian Interview Protocol. The BCLS and ACLS examinations established baseline cognitive knowledge. The demographic form recorded age, ethnicity, clinical areas in which the subjects worked, length of employment, and last certification. The Garabedian Interview Protocol, a semi-structured 20 question protocol, was used to elicit information regarding the subjects' perceptions about enablers and barriers. In the sample (N = 15), eight nurses and seven physicians, all subjects satisfactorily passed the BCLS and ACLS cognitive examinations with scores higher than the 84% standard established by the American Heart Association (AHA). The demographic information revealed no significant differences among the subjects. Data collected using the Garabedian Interview Protocol indicated that there were more barriers than enablers to the retention of skills. The barrier mentioned most often was length of time between recertifications. The subjects also felt that insufficient time spent with training mannequins resulted in low confidence levels and anxiety. Enablers identified during the study included AHA algorithms that are key mechanisms for retaining skills, instructor support during certification and recertification, as well as preparedness for the recertification. If acute care hospitals are to successfully achieve effective skill retention levels in their professionals, educational programs need to be improved to provide additional methods for proficiency enhancement in cardiac life support skills.