title: ICU nurses' perceptions of potential constraints and anticipated support to practice defibrillation: a qualitative study.
abstract: OBJECTIVE
  The study examines the experience of intensive care nurses in caring for patients in cardiac arrest, and their perceptions of introducing nurse-led defibrillation.
  
  
  METHODS
  This was a descriptive, exploratory and qualitative study at an intensive care unit (ICU) of an acute regional hospital in Hong Kong. Twelve registered nurses were purposefully selected for interview.
  
  
  RESULTS
  Although all the participants were trained in basic life support, only 50% were trained in advanced cardiac life support (ACLS), and those trained in ACLS described having limited opportunities to apply their defibrillation knowledge. Whilst participants believed that they were theoretically prepared to influence the patient's resuscitation outcomes, newly qualified nurses were reluctant to be accountable for defibrillation. In contrast, experienced nurses were more willing to perform nurse-led defibrillation. Support from management, cooperation between nurses and doctors, regular in-hospital 'real-drill' programmes, sponsorship for training, and the use of alternative defibrillation equipment should be considered to encourage nurse-led defibrillation in ICU settings.
  
  
  CONCLUSIONS
  Nurse-led defibrillation is an approach of delivering prompt care to critically ill patients, and a way ahead for intensive care nursing in Hong Kong. Emphasis on a consistent policy to promote nurse-led defibrillation practice is needed.
authors.affiliation: Intensive Care Unit, United Christian Hospital, 130, Hip Wo Street, Kwun Tong, Hong Kong. mcmug.org.hk@gmail.com
authors.forename: George C M
authors.initials: GC
authors.lastname: Hui
authors.forename: Lisa P L
authors.initials: LP
authors.lastname: Low
authors.forename: Iris S F
authors.initials: IS
authors.lastname: Lee
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000451:nursing*; D002983:Clinical Competence; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004554:Electric Countershock / Q000451:nursing*; D006323:Heart Arrest / Q000401:mortality / Q000451:nursing*; D006801:Humans; D007362:Intensive Care Units; D009741:Nursing Staff, Hospital / Q000523:psychology; D017180:Tachycardia, Ventricular / Q000451:nursing; D014693:Ventricular Fibrillation / Q000451:nursing