In-hospital resuscitation: association between ACLS training and survival to discharge.
BACKGROUND
No data have been published on the relationship between advanced cardiac life support (ACLS) training of the individual who initiates resuscitation efforts and survival to discharge.


OBJECTIVE
To determine whether patients whose arrests were discovered by nurses trained in ACLS had survival rates different from those discovered by nurses not trained in ACLS.


METHODS
Cohort case-comparison.


METHODS
A 550-bed, tertiary care center in central Georgia.


METHODS
Patients whose cardiopulmonary arrest was discovered by a nurse who activated the in-hospital resuscitation mechanism.


METHODS
Patient survival to discharge.


RESULTS
Initial rhythm was strongly related to survival to discharge and individually associated with 57% of the variability in survival. Nurse's training in advanced cardiac life support was also strongly related to survival and individually associated with 29% of the variability. Combining both the variables determined 62% of the variability in survival to discharge. Patients discovered by an ACLS-trained nurse (n=88) were about four times more likely to survive (33 survivors, 38%) than were patients, discovered by a nurse without training in ACLS (n=29, three survivors, 10%).


CONCLUSIONS
Arrest discovery by nurses trained in ACLS is significantly and dramatically associated with higher survival-to-discharge rates.
Dane
F C
FC
Departments of Psychology and Internal Medicine, Medical Center of Central Georgia, Mercer University, 707 Pine Street, Macon, GA 31201, USA. dane_fc@mercer.edu
Russell-Lindgren
K S
KS
Parish
D C
DC
Durham
M D
MD
Brown
T D
TD
D022561:Advanced Cardiac Life Support / Q000193:education*; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D004506:Education, Nursing; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006760:Hospitalization; D006801:Humans; D009726:Nurses; D010351:Patient Discharge; D016019:Survival Analysis; D013997:Time Factors