Exploring the expanded roleof nurses in critical care

Hind, Martin; Jackson, Dawn; Andrewes, Clive; Fulbrook, Paul; Galvin, Kathleen; Frost, Susan

doi:10.1016/s0964-3397(99)80045-7

Cited by 26 publications

(24 citation statements)

References 9 publications

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“…6 There has been considerable support among nurses for role expansion in the critical care setting. 7 This, combined with a simultaneous reduction of junior doctors' working hours in the UK and the need for cost containment within the National Health Service (NHS), prompted the development of a local initiative to extend nursing practice to include elective cardioversion of patients with persistent AF. 8 …”

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confidence: 99%

The safety and effectiveness of a nurse led cardioversion service under sedation

Boodhoo

2004

Heart

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Objective: To assess the safety and effectiveness of nurse led elective cardioversion of atrial fibrillation under sedation. Design: Prospective, longitudinal study. Setting: Cardiac catheterisation laboratory and recovery area of a district general hospital. Patients: 300 patients referred for elective cardioversion of persistent atrial fibrillation. Interventions: Pre-procedure evaluations (history, physical examination, blood tests), consent, sedation administration, cardioversions, and post-procedure monitoring until discharge by advanced life support certified coronary care unit nurses trained in the techniques. A doctor was immediately available if required but not present. Main outcome measures: Success rates at discharge and at six weeks, energy delivered, number of shocks, dose of sedation, immediate, 24, and 48 hour patient perceptions, complications, waiting times, and cost effectiveness. Results: Cardioversion success rate was 87% at discharge and 48% at six weeks. Mean (SD) cumulative energy was 497 (282) J and number of shocks 1.6 (0.8). Mean (SD) dose of sedation was 23 (9) mg intravenous diazepam. No patient required reversal of sedation, airway support, or medical intervention. Ninety eight per cent of patients had no pain or recall of the procedure. Four patients who were adequately anticoagulated experienced embolic phenomena. Ninety eight per cent of patients would repeat the procedure if necessary. Without requirement for a physician or anaesthetist, waiting times for elective cardioversion fell from three months to under four weeks. There was a significant reduction in the estimated cost of the procedure from £337 with general anaesthesia to £130 with nurse led sedation and cardioversion (p , 0.001). Conclusion: With appropriate training, a nurse led cardioversion service with sedation is safe, effective, well tolerated, and cost efficient.

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confidence: 99%

The safety and effectiveness of a nurse led cardioversion service under sedation

Boodhoo

2004

Heart

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“…The use of technology is also intrinsic to cardiac nursing and is used by nurses to detect changes in the condition of their patients. The increased use of technology and technological roles within nursing are seen by some cardiac nurses as an opportunity to provide more holistic care [16]. They are also seen by patients as a reassurance and the ability of the nurse to manage such technology is seen as an extremely valuable attribute.…”

Section: Discussionmentioning

confidence: 99%

What is the Role of the Coronary Care Nurse? A Review of the Literature

Jones

Johnson

2008

European Journal of Cardiovascular Nursing

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“…In the caring relation, they improved and developed their caring competence. Hind et al. (1999) found that responding to the patient's needs has the strongest influence on nurses in the process of developing their practice.…”

Section: Discussionmentioning

confidence: 99%