Cardiopulmonary resuscitation: a mandatory training program for nursing staff.
At Flinders Medical Centre, a 600 bed teaching hospital in Adelaide, South Australia, there are between eighty and one hundred cardiac arrests in the general wards areas each year. From the time an arrest occurs until the arrest team arrives, the patient's life will depend on the speed with which Cardiopulmonary Resuscitation (CPR) is initiated and the effectiveness of the CPR performed by ward staff. The outcome of cardiac arrest patients who receive promptly administered CPR is extensively documented in literature on the subject. When an arrest occurs in the ward at Flinders, staff activate an emergency call to the "cardiac arrest team", which consists of three medical staff members and one nursing staff member. The nurse, from the IntensiveCare Unit, is responsible for coordinating the actions of the nursing staff during the arrest. Following the arrest an audit sheet is completed with details of the patient, the arrest, treatment, and any other pertinent information. Until 1985 it was not unusual at Flinders for arrest audit sheets to have comments such as: "CPR not performed by ward staff" or "CPR not being performed correctly by ward staff" or, even worse, "Ward staff disappeared when the arrest team arrived". In many hospitals throughout Australia this was, and may still be, a familiar problem. The nursing department at Flinders believed that if a program could be established in which nurses were given the opportunity to learn and practise CPR, they could gain the skills necessary to perform basic CPR