1Division of Nursing, Research Institute of Nursing Science, HallymUniversity, Chuncheon
2Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
Copyright © 2015 Korean Society of Adult Nursing
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Nurses' CPR Performance Scales
| Items | Critical action | Range of scores | Scale | |||
|---|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | |||
| Assessment | Check unresponsiveness | 0~1 | no | yes | ||
| Call for help | 0~1 | no | yes | |||
| Check pulse | 0~1 | no | yes | |||
| Start CPR | Time to initiate chest compression | 0~2 | 60 sec ＞ | 30~60 sec | 30 sec ＜ | |
| Apply back board | 0~2 | no | incorrect | correct | ||
| Initiate BVM ventilation | 0~2 | no | incorrect | correct | ||
| Connect to oxygen | 0~2 | no | incorrect | correct | ||
| Quality of CPR | Mean rate of correct compression rate (%) | 0~3 | NC | 50% ＜ | 50~80% | 80% ＞ |
| Mean rate of correct placement of hands (%) | 0~3 | NC | 50% ＜ | 50~80% | 80% ＞ | |
| Mean rate of correct compression depth (%) | 0~3 | NC | 50% ＜ | 50~80% | 80% ＞ | |
| Mean rate of full chest recoil (%) | 0~3 | NC | 50% ＜ | 50~80% | 80% ＞ | |
| 30 compression and 2 ventilation | 0~2 | NC or BVM | incorrect | correct | ||
| Hands off time |
0~2 | 2 min ＞ | 1~2 min | 1 min ＜ | ||
| Defibrillation | Check ECG rhythm | 0~2 | no | incorrect | correct | |
| Give a shock (defibrillation) | 0, 2 | no | yes | |||
| Select a shock energy and charge | 0~1 | no or incorrect | correct | |||
| Place the defibrillator paddle in AP | 0~1 | no | yes | |||
| Clear the victim before delivering a shock | 0~1 | no | yes | |||
| Time to deliver first shock | 0~2 | no shock | 2min ＞ | 2 min ＜ | ||
| Drug | Administer epinephrine | 0~1 | no | yes | ||
CPR=cardiopulmonary resuscitation; BVM=bag valve mask; ECG=electrocardiography; NC=no compression; AP=appropriate position;
†Total compression interruption time during 5 minutes.
Non-technical Skills Rating during 5 minutes Simulated Cardiac Arrest (N=28)
| Variables | Behavior marker | None | Incomplete or untimely | Complete & timely |
|---|---|---|---|---|
| n (%) | n (%) | n (%) | ||
| Leadership | Clearly identified in team | 2 (7.1) | 12 (42.9) | 14 (50.0) |
| Communicate efficiently | 6 (21.4) | 15 (53.6) | 7 (25.0) | |
| Delegate (distribute) tasks | 6 (21.4) | 12 (42.9) | 10 (35.7) | |
| Manage workload and resource | 11 (39.3) | 4 (14.3) | 13 (46.4) | |
| Communication | Use closed loop communication (check-back) | 9 (32.1) | 5 (17.9) | 13 (46.4) |
| Call for help appropriate/think out loudly | 8 (28.6) | 7 (25.0) | 13 (46.4) | |
| Mutual performance monitoring | Unnecessary hand-off time corrected | 19 (67.9) | 4 (14.3) | 5 (17.9) |
| Hyper- or hypoventilation corrected | 23 (82.1) | 3 (10.7) | 2 (7.1) | |
| Check & speak out the rhythm | 8 (28.6) | 5 (17.9) | 15 (53.6) | |
| Knowledge sharing, situation monitoring | 12 (42.9) | 5 (17.9) | 11 (39.3) | |
| Maintaining of standards and guideline | Defibrillation is performed safely | 10 (35.7) | 5 (17.9) | 13 (46.4) |
| Change person performing chest compression | 7 (25.0) | 4 (14.3) | 17 (60.7) | |
| every 2 min. | ||||
| Ensuring cardiac rhythm after 5 cycles | 9 (32.1) | 7 (25.0) | 12 (42.9) | |
| Task management | Back-up behavior provided as needed (support other team members) |
2 (7.1) | 7 (25.0) | 19 (67.9) |
| All team members contribute with behavior | 2 (7.1) | 3 (10.7) | 23 (82.1) |
Nurses' CPR Performance Scores during 5 minutes Simulated Cardiac Arrest (N=28)
| Variables | Critical action | Scale | M±SD (possible range) | |||
|---|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | |||
| n (%) | n (%) | n (%) | n (%) | |||
| Assessment | Check unresponsiveness | 0 (0.0) | 28 (100.0) | 2.50±0.58 | ||
| Call for help | 1 (3.6) | 27 (96.4) | (0~3) | |||
| Check pulse | 13 (46.4) | 15 (53.6) | ||||
| Start CPR | Time to initiate chest compression | 3 (10.7) | 5 (17.9) | 20 (71.4) | 5.57±1.83 | |
| Apply back board | 6 (21.4) | 7 (25.0) | 15 (53.6) | (0~8) | ||
| Initiate BVM ventilation | 1 (3.6) | 16 (57.2) | 11 (39.3) | |||
| Connect to oxygen | 9 (32.1) | 1 (3.6) | 18 (64.3) | |||
| Quality of CPR | Mean rate of correct compression rate (%) | 5 (17.9) | 21 (75.0) | 3 (10.7) | 4 (14.3) | 11.28±1.36 |
| Mean rate of correct placement of hands (%) | 4 (14.3) | 7 (25.0) | 17 (60.7) | (0~16) | ||
| Mean rate of correct compression depth (%) | 13 (46.4) | 9 (32.1) | 6 (21.4) | |||
| Mean rate of full chest recoil (%) | 6 (21.4) | 22 (78.6) | 28 (100.0) | |||
| 30 compression and 2 ventilation | 21 (75.0) | 2 (7.1) | ||||
| Hands off time |
||||||
| Defibrillation | Check ECG rhythm | 7 (25.0) | 6 (21.4) | 15 (53.6) | 6.07±3.05 | |
| Give a shock (defibrillation) | 5 (17.9) | 21 (75.0) | 23 (82.1) | (0~9) | ||
| Select a shock energy and charge | 7 (25.0) | 20 (71.4) | ||||
| Place the defibrillator paddle in AP | 8 (28.6) | 20 (71.4) | ||||
| Clear the victim before delivering a shock | 8 (28.6) | 23 (82.1) | ||||
| Time to deliver first shock | 5 (17.9) | |||||
| Drug | Administer epinephrine | 15 (53.6) | 13 (46.4) | NA | ||
| Total scores | 27.32±4.59 | |||||
CPR=cardiopulmonary resuscitation; BVM=bag valve mask; ECG=electrocardiography; AP=appropriate position; NA=not applicable;
†Total compression interruption time during 5 minutes.
Association NTSs and CPR Performance during 5 minutes Simulated Cardiac Arrest (N=28)
| Variables | Groups | CPR performance Median (IQR) |
Mann- Whitney U |
Z | p |
|---|---|---|---|---|---|
| Total NTSs | Better (n=16) | 29.5 (27.0~31.8) | 43.5 | -2.447 | .014 |
| Worse (n=12) | 25.0 (23.0~28.8) | ||||
| Leadership | Better (n=14) | 29.5 (26.8~31.3) | 56.0 | -1.938 | .053 |
| Worse (n=14) | 25.5 (22.8~29.3) | ||||
| Communication | Better (n=15) | 30.0 (27.0~32.0) | 49.5 | -2.220 | .026 |
| Worse (n=13) | 26.0 (24.0~28.5) | ||||
| Mutual performance monitoring | Better (n=18) | 30.0 (26.75~32.0) | 31.5 | -2.816 | .005 |
| Worse (n=10) | 25.0 (21.5~28.3) | ||||
| Maintaining of standards and guideline | Better (n=17) | 30.0 (27.0~32.0) | 30.5 | -2.975 | .003 |
| Worse (n=11) | 25.0 (23.0~28.0) | ||||
| Task management | Better (n=19) | 29.0 (25.0~32.0) | 50.0 | -1.753 | .080 |
| Worse (n=9) | 26.0 (21.0~29.0) |
NTSs=non-technical skills; CPR=cardiopulmonary resuscitation; IQR=interquartile range.
CPR=cardiopulmonary resuscitation; BVM=bag valve mask; ECG=electrocardiography; NC=no compression; AP=appropriate position; Total compression interruption time during 5 minutes.
CPR=cardiopulmonary resuscitation; BVM=bag valve mask; ECG=electrocardiography; AP=appropriate position; NA=not applicable; Total compression interruption time during 5 minutes.
NTSs=non-technical skills; CPR=cardiopulmonary resuscitation; IQR=interquartile range.
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