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Seeking an explanation for the poor uptake of in-hospital AED programs
Tom A Laws1, Kathryn Zeitz, Brenton A Fiedler
1Division of Health Sciences, School of Nursing and Midwifery, University of South Australia, City East Campus Nth Terrace, Adelaide 5000, Australia. tom.laws@unisa.edu.au
Insights
Automated external defibrillators (AEDs) are recommended for in-hospital cardiac arrest (CA) but are infrequently used. This study explores barriers to AED adoption in hospitals, highlighting potential benefits for occupational safety and cost-effectiveness.
Area of Science:
- Emergency Medicine
- Healthcare Management
- Occupational Health
Background:
- Automated external defibrillators (AEDs) are crucial for out-of-hospital cardiac arrest (OHCA) and recommended for in-hospital basic life support (BLS).
- Despite recommendations from resuscitation organizations, AED implementation in hospitals remains sporadic and inconsistent.
- This inconsistency impacts nurses and patients, who are vital for BLS practices.
Purpose of the Study:
- To investigate the extent of the problem regarding slow AED uptake in hospitals.
- To identify factors contributing to the limited implementation of AED programs within healthcare facilities.
- To highlight the potential benefits of AEDs for nurses and other first responders in terms of Occupational Health Safety and Welfare (OHS and W).
Main Methods:
- A pilot study was conducted to assess the current situation.
- A comprehensive review of existing literature was performed to understand barriers and contributing factors.
- Analysis included consideration of cost factors associated with AED acquisition and implementation.
Main Results:
- The study identified a significant gap between recommended AED use and actual hospital implementation.
- Factors contributing to slow adoption include potential cost concerns for hospital budgets.
- Nurses and other in-hospital first responders stand to gain considerably from improved Occupational Health Safety and Welfare (OHS and W) with AED access.
Conclusions:
- There is a clear need to understand public hospital resistance to AEDs.
- Further research is required to determine the practical occupational, social, and economic advantages of AEDs in public hospitals.
- Addressing these factors could improve in-hospital cardiac arrest management and patient outcomes.
Abstract:
The automated external defibrillator (AED) has been adopted by emergency service personnel as a first-line intervention in the management of out-of-hospital cardiac arrest (OHCA). AED leads to more successful Advanced Cardiac Life Support; consequently, national resuscitation organisations worldwide have recommended that nurses and doctors also integrate AEDs as a component of their basic life-support response to cardiac arrest. Despite these recommendations, the implementation of AED programs within hospitals has been generally sporadic and isolated. A continuation of this situation will most likely disturb and perplex nurses and patients, as they are key stakeholders with respect to upholding recommended BLS practices. In the absence of any explanation from change agents within hospitals, this paper seeks, by way of a pilot study and a review of the literature, to identify the extent of the problem and identify factors contributing to the relatively slow uptake of this device. We argue that nurses and other first responders to in-hospital cardiac arrest (CA) have much to gain, in the context of Occupational Health Safety and Welfare (OHS and W), from ready access to AEDs. Cost factors are also considered, with initial cost of AED purchase likely to be a major concern for managers of hospital budgets. The issues we discuss in this paper clearly support the need for further research to (a) explain the nature of public hospital resistance to AEDs and (b) to consider whether AEDs will provide practical advantages to public hospitals from an occupational, social and economic perspective.
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