Heart & lung : the journal of critical care
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Randomized Controlled Trial Clinical Trial
Retention of cardiopulmonary resuscitation skills among nursing personnel: what makes the difference?
The American Association of Critical-Care Nurses' Position Statement on cardiopulmonary resuscitation (CPR) certification states that "nurses who care for the critically ill must have annual BCLS or CLS certification...." Review of literature, however, did not reveal any studies among nurses that examined the question of whether Basic Cardiac Life Support (BCLS) was superior to other forms of CPR education, such as Basic Life Support-A (BLS-A) (Heartsaver). The purpose of this 2 by 3 factorial design study was to examine the relationship between the method of instruction and the quality of retention of one-person CPR skills at 4 and 8 months after the initial class. The two methods of instruction under consideration were a BLS-course A (hospital-wide Heartsaver course) and a BLS-course C (Basic Cardiac Life Support course). ⋯ Other variables that were described in the literature were education, practice of skills, current position, years in profession, previous CPR training, motivation, and felt level of competence. These variables also were included in the study to find out the total variable impact on CPR retention. At least 30 registered nurses were selected from each of the high, medium, and low use areas and randomly assigned to one of the instruction groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Relationship between arterial and venous activated partial thromboplastin time values in patients after percutaneous transluminal coronary angioplasty.
This quasi-experimental study was conducted to determine whether reliable activated partial thromboplastin time (APTT) values could be obtained from samples taken from indwelling arterial catheter lines. The 30 subjects, who were receiving heparin infusions after a percutaneous transluminal coronary angioplasty (PTCA), had femoral intraarterial lines. With use of a counterbalanced design, APTT values determined in two serial samples of venous and arterial blood were compared for the 30 subjects. ⋯ The histogram indicated that three of the 30 subjects had arterial-venous APTT differences that exceeded 19 seconds when four times the discard volume was used. In the samples where six times the discard volume were used, only one person had an APTT reading greater than 8 seconds. Paired t tests revealed statistically significant differences between the arterial and venous APTT values (t = 2.95, df = 29, p less than 0.01) for discards of four times the catheter dead space volume, whereas no statistically significant difference was found between the arterial and venous APTT values (t = 2.62, df = 28, p greater than 0.01) for discards of six times the dead space volume.(ABSTRACT TRUNCATED AT 250 WORDS)
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Pulse oximetry represents a major advance in noninvasive oxygenation monitoring in critically ill adults. Its technology has given practitioners a safe, accurate, and continuous method for assessing arterial oxygen saturation. ⋯ The clinical utility of pulse oximetry monitoring in critically ill adults is discussed, with consideration given to patient selection and specific procedures that incur hypoxemic risk. Issues of quality assurance and risk management that surround the use of pulse oximetry are addressed.