title: Nurse-initiated defibrillation: are nurses confident enough?
abstract: OBJECTIVE
  To determine the capability of nurses to identify ventricular fibrillation (VF) and ventricular tachycardia (VT) rhythms on an ECG and carry out subsequent defibrillation on their own as soon as they identify and confirm cardiac arrest.
  
  
  METHODS
  This was a prospective cohort study to determine the capability of emergency department (ED) nurses to recognise VF or pulseless VT correctly and their willingness to perform defibrillation immediately in an ED of a teaching hospital in Hong Kong. A questionnaire was completed before and after a teaching session focusing on the identification of rhythms in cardiac arrest and defibrillation skills. Correct answers for both ECG interpretation and defibrillation decisions scored one point for each question. The differences in mean scores between the pre-teaching and post-teaching questionnaires of all nurses were calculated.
  
  
  RESULTS
  51 pre-teaching and 43 post-teaching questionnaires were collected. There were no statistically significant changes in ECG scores after teaching. For defibrillation scores, there was an overall improvement in the defibrillation decision (absolute mean difference 0.42, p=0.014). Performance was also improved by the teaching (absolute mean difference 0.465, p=0.046), reflected by the combination of both scores. Two-thirds (67%) of nurses became more confident in managing patients with shockable rhythms.
  
  
  CONCLUSIONS
  Nurses improve in defibrillation decision-making skills and confidence after appropriate brief, focused in-house training.
authors.affiliation: Prince of Wales Hospital, New Territories, Hong Kong SAR, China. rolltai@hotmail.com
authors.forename: C K
authors.initials: CK
authors.lastname: Tai
authors.forename: Giles N
authors.initials: GN
authors.lastname: Cattermole
authors.forename: Paulina S K
authors.initials: PS
authors.lastname: Mak
authors.forename: Colin A
authors.initials: CA
authors.lastname: Graham
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Rainer
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000451:nursing; D002983:Clinical Competence / Q000592:standards*; D004554:Electric Countershock / Q000451:nursing*; D004562:Electrocardiography / Q000451:nursing; D004636:Emergency Service, Hospital; D006323:Heart Arrest / Q000175:diagnosis / Q000628:therapy; D006723:Hong Kong; D006784:Hospitals, Teaching; D006801:Humans; D009741:Nursing Staff, Hospital / Q000193:education; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D017180:Tachycardia, Ventricular / Q000175:diagnosis*; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000451:nursing