title: Factors influencing the intentions of nurses and respiratory therapists to use automated external defibrillators during in-hospital cardiac arrest: a qualitative interview study.
abstract: Nurses and respiratory therapists are seldom allowed to use automated external defibrillators (AED) during in-hospital cardiac arrest. This can result in significant time delays before defibrillation occurs and lower survival for cardiac arrest victims. We sought to identify barriers and facilitators to AED use by nurses and respiratory therapists.
  
  
  
  We conducted semi-structured qualitative interviews with a purposeful sample of nurses and respiratory therapists. We developed the interview guide based on the constructs of the theory of planned behaviour, which elicits salient attitudes, social influences, and control beliefs potentially influencing the intent to use an AED. Interviews were recorded, transcribed verbatim, and analysed until achieving data saturation. Two independent reviewers performed inductive analyses to identify emerging categories and themes, and ranked them by frequency of the number of participants stating the topic.
  
  
  
  Demographics for the 24 interviewees include mean age 40.5, 79.2% female, 87.5% performed cardiopulmonary resuscitation (CPR), 29.2% defibrillated a patient. Identified attitudes pertained to the timeliness of defibrillation, patient survival, simplicity of AED use, accuracy of rhythm recognition, and harm to self or others. Social influences consisted of physician and hospital administration support of AED use. Control beliefs included training on AED use, policy allowing AED use, familiarity with AED, and task burden during resuscitation.
  
  
  
  Most nurses and respiratory therapists intended to use an AED if permitted to do so by a medical directive. Successful implementation would require educational initiatives focusing on safety and efficacy of AEDs, support from physicians and hospital administrators, and additional training on AED use.
authors.affiliation: *Department of Surgery,Queen's University,Kingston,ON.
authors.forename: Jessica
authors.initials: J
authors.lastname: Andrews
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Christian
authors.initials: C
authors.lastname: Vaillancourt
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Jan
authors.initials: J
authors.lastname: Jensen
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Ann
authors.initials: A
authors.lastname: Kasaboski
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Manya
authors.initials: M
authors.lastname: Charette
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Clement
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Brehaut
authors.affiliation: ¶Department of Pediatrics,University of Ottawa,Ottawa,ON.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Osmond
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
authors.affiliation: †Ottawa Hospital Research Institute,University of Ottawa,Ottawa,ON.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Grimshaw
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011361:Professional Competence; D036301:Qualitative Research; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: allied health personnel; defibrillators; heart arrest; nurses