How Good Are Your CPR Skills? Research Shows Monthly Practice Is Crucial

A nurse practices CPR on a voice advisory manikin. Photo courtesy of Laerdal Medical.

By Maureen Shawn Kennedy, AJN editor-in-chief

Most of you are probably aware of the AHA’s revised CPR guidelines that were issued in 2010. They include a major change in the resuscitation sequence—which now begins with chest compressions rather than ventilation—and emphasize the importance of achieving adequate compression of the chest—“at least two inches (5 cm)”—to achieve adequate blood flow. (You can see a video by the AHA demonstrating the new guidelines here.)  This change is especially important in light of recent research on CPR skills.

In 2011, Marilyn H. Oermann and colleagues conducted research with nursing students to determine how often one needs to practice CPR skills to maintain competence. 

As she explains in an article in the May issue of AJN, students who practiced briefly each month not only maintained their skills, but improved them significantly by the end of 12 months.

In comparison, the skills of those who only  had an initial training session deteriorated after three months; by 12 months, few could perform CPR adequately, especially in terms of achieving adequate depth for chest compressions. And although these were students, Oermann describes studies showing similar results with paramedics, non-ICU nurses, and nurse anesthetists. 

Most hospitals and agencies only require an annual review or demonstration of skills to be recertified in CPR; few, I bet, measure the depth of compressions. Sounds like it’s time to revisit this […]

2016-11-21T13:10:10-05:00May 11th, 2012|Nursing|1 Comment
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Administering Drugs through a Feeding Tube—Are You Sure You’re Doing It Right?

Drug Administration through an EFT

By Sylvia Foley, AJN senior editor

Research indicates that a “surprising number of nurses”  fail to follow guidelines for preparing and delivering drugs through an enteral feeding tube. (Do you find this surprising? Tell us in the comments!) This can result in medication error and tube obstruction, reduced drug effectiveness, and an increased risk of toxicity.

In this month’s CE feature Drug Administration Through an Enteral Feeding Tube, author Joseph I. Boullata describes the factors to consider before doing so and examines the gap between recommended and common practice. He also explains what the most recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend and why.

The ASPEN guidelines include:

  • Do not add medication directly to an enteral feeding formula.
  • Administer each medication separately though an appropriate access site.
  • Liquid dosage forms should be used when available and if appropriate; only immediate-release solid dosage forms may be substituted.
  • Dilute the solid or liquid medication as appropriate and administer using a clean oral syringe.
  • Avoid mixing medications intended for administration through an EFT.

For the complete guidelines, check out Table 1 in the article. And for more on this and other aspects of  enteral nutrition, visit ASPEN to read the full 2009 Enteral Nutrition Practice Recommendations. (ASPEN guidelines are free, but site registration is required.)

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2016-11-21T13:21:58-05:00October 5th, 2009|nursing research|2 Comments
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Can School Nurses Help Prevent Heat Stroke Fatalities in High School Football?

Shawn Kennedy, MA, RN, AJN editorial director & interim editor-in-chief

by Bludgeoner86, via Flickr

Earlier this month, Diana Mason, AJN’s editor-in-chief emeritus, wrote here about head injuries in soccer. A related news story about high school sports should make all school nurses, coaches, and parents take notice: student athletes suffer—and sometimes die—from heat stroke during intense workouts in hot weather.

According to an Associated Press report, Fred Mueller, director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina, attributes 39 deaths since 1995 to heat-related causes. And that doesn’t count three deaths this past summer that he notes may also be associated with heat stroke.

Most of the deaths are associated with football preseason training in August. My middle son played high school football and every August he went to “preseason camp.” He and his teammates slept on air mattresses in the non-air-conditioned high school gym, and spent the last week of summer vacation in grueling drills and practices, wearing shorts, T-shirts, shoulder pads, and helmets. One year he arrived home looking thin and gaunt. He related stories of teammates vomiting on the sidelines during practices and of restricted water breaks. It took a player fainting during one session and an onslaught of parent complaints and pressure […]

2016-11-21T13:22:21-05:00September 17th, 2009|nursing perspective|1 Comment
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Vaccine Wars Ensue as H1N1 Mutates – Just Alarmist Sci-Fi Fantasy?

Picture this: in early September of this year, the novel H1N1 influenza virus mutates into a strain that can quickly lead to wracking fevers, violent vomiting, respiratory failure, dehydration, and death. It is also highly resistant to existing antiviral agents. The first cases of this new strain are identified after a spate of deaths in a Kansas City nursing home as well as among members of a church choir in the same city. The new strain quickly shows up in a number of major metropolitan areas in the U.S. and then in several European countries. As hospitals are swamped and the number of deaths rises unabated, borders are sealed between countries—but it's too late to stop the new strain from spreading as the fall and winter flu season gets into full swing.

2016-11-21T13:25:13-05:00July 16th, 2009|Nursing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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