2001 OPEN FORUM Abstracts
FREQUENCY AND IMPORTANCEOF ACLS SKILLS IN ADULT RESPIRATORY CARE
Hoberty PD,EdD, RRT, Fenske S., BS, RRT, and Yokum J., BS, RRT. The Ohio State UniversityHealth Sciences Center, The Ohio State University, Columbus, Ohio.
Background: ACLS Providertraining has become a part of the educational preparation of the graduate advancedrespiratory therapist. However, how often these skills are employed or how importantthey are in the work setting is not well documented. The purpose of this studywas to determine the frequency and importance of ACLS skills for respiratorytherapists responding to in-hospital resuscitations in the acute care setting.Further, we wished to determine if there was a difference according to hospitalsize.
Method: We surveyed a sampleof 100 acute care hospitals in Ohio by using a written questionnaire. The surveyasked department managers to rate each of 17 skills as to frequency and importancein in-hospital resuscitations on a 5 point Lickert-style scale. The sample wasstratified into 3 groups according to hospital size. The skills were derivedfrom American Heart Association ACLS Provider Instructor Manual, 1997.
Results: 54 respondents returnedusable questionnaires. Approximately equal numbers came from each hospital size.The need for ACLS Provider certification was supported by 98% of the respondents,although only 22% indicated that all of the therapists on their resuscitationteam were ACLS certified. Based on frequency, 8 skills were determined to bewithin the current practice of the advanced practitioner. In order of frequencyperformed they are: recognize lethal heart rhythms on an EKG, recognize majorACLS conditions, recognize non-lethal heart rhythms on an EKG, early managementof ACLS conditions, perform endotracheal intubation, suggest ACLS pharmacology,provide defibrillation with a conventional defibrillator, and perform cardioversionwith a conventional defibrillator. An ANOVA showed that the frequency of oneskill - early management of ACLS conditions - varied by hospital size with therapistsin smaller and larger hospitals performing the skill more frequently than thosein medium size hospitals. In general, the ratings of frequency and importancedid not correlate with one another.
Conclusion: Although ACLSmerits a position in the training of advanced therapists, more than half ofthe skills are very infrequently or never used by therapists. The results promptus to question the need for full ACLS training of all therapists who participatein resuscitations.