Does immediate life support training influence nurses’ skill deployment during cardiac arrest

Introduction: Early defibrillation is the main determinant of survival in cardiac arrest. Recently the Resuscitation Council have piloted the development of the Immediate Life Support (ILS) Course in this large teaching hospital. ILS aims to expedite resuscitation by training hospital staff to defibrillate the patient and insert a laryngeal mask (LMA), before the crash team arrive (Resuscitation Council 2001). Aim and Method: The aim of this study was to explore the relationship between ILS training and nurses’ use of these skills in a cardiac arrest situation. Our first objective was to use a pretest post-test design to compare the rate of skill deployment by appropriately trained nurses in two consecutive 12 month periods before and after the introduction of ILS training. Data were entered onto SPSS and analysed using standard parametric statistics. Secondly, we used qualitative interviews with a purposive sample of 12 ILS trained nurses who had subsequently attended a cardiac arrest, to explore the main factors associated with skill deployment. Interviews were taped, transcribed and analysed using Colaizzi’s 1978 approach. Results: In this two-year period 668 nurses received ILS training. Data from 352 cardiac arrests were analysed. After the implementation of ILS training 103 patients were defibrillated and 99 LMA’s were inserted. No statistical difference (p=>0.05) was found in the deployment of ILS skills by nurses before and after training. Qualitative interviews generated four main themes: • ILS training increases competence • Skills are a ‘stop-gap’ • Crash team take control • Experience breeds confidence Each theme will be described to develop an understanding of the complex range of factors influencing why nurses in this study tended not to use ILS skills in a subsequent arrest situation. Conclusion: This study suggests that an ILS course alone many be insufficient to increase general nurses’ use of ILS skills. We propose further research on this topic.