Nurses' attitudes towards resuscitation and national resuscitation guidelines--nurses hesitate to start CPR-D

National resuscitation guidelines were published in Finland in 2002 and updated in 2006. The purpose of this study was to analyse the effect of cardiopulmonary resuscitation (CPR) education on attitudes towards defibrillation during arrests (CPR-D) and the guidelines.

In 2003 (before CPR-D education) and in 2007 (after the education), 48-item questionnaires (using a 7-point Likert scale: 1=totally disagree, 7=totally agree) were sent to nurses in a secondary hospital. Factor loadings were applied using maximum likelihood factor analyses with a varimax rotation. Five scales were built from the items of the questionnaire: attitudes towards CPR-D, positive attitudes, negative attitudes towards guidelines, implementation and nurses' role.

A total of 297 and 199 responded in 2003 and 2007, respectively. Education increased positive attitudes towards CPR-D (scale mean: 4.40 vs. 3.61, 95% confidence interval (CI): 3.9-4.2, P<0.001). Nevertheless, 27% of nurses hesitated to perform defibrillation because of fear of injuring patient and 64% because of anxiety. After education, negative attitudes towards guidelines increased (scale mean 2.94 vs. 3.92, 95% CI: 3.2-3.6, P<0.001) and nurses were more unsure about their role than before education (scale mean: 4.84 vs. 3.42, 95% CI: 4.1-4.4, P<0.001).

Intensive education increased self-confidence regarding CPR-D skills but did not reduce anxiety. CPR-D education should include a focus on reducing anxiety, and negative attitudes within organisations need to be explored.