title: The initiation and administration of drugs for advanced life support by critical care nurses in the absence of a medical practitioner.
abstract: Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs, Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position. The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation. A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.
authors.affiliation: School of Nursing, Deakin University, Melbourne, Vic.
authors.forename: Rochelle
authors.initials: R
authors.lastname: Wynne
authors.forename: Teresa
authors.initials: T
authors.lastname: Lodder
authors.forename: Tony
authors.initials: T
authors.lastname: Trapani
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Hanlon
authors.forename: Carmel
authors.initials: C
authors.lastname: Cleary
mesh_terms: D001291:Attitude of Health Personnel; D002568:Certification; D002983:Clinical Competence / Q000592:standards; D003422:Critical Care / Q000458:organization & administration*; D004358:Drug Therapy / Q000451:nursing*; D004509:Education, Nursing, Continuing; D004651:Employment / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008020:Life Support Care / Q000458:organization & administration*; D008119:Lobbying; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D017009:Professional Autonomy; D013041:Specialties, Nursing / Q000193:education / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013997:Time Factors; D014739:Victoria