Cardiac arrest resuscitation policies and practices: a survey of Australian hospitals.

OBJECTIVE To describe the policy and practice relating to cardiopulmonary resuscitation (CPR) and defibrillation in cardiac arrest in Australian hospitals. DESIGN Cross-sectional postal survey conducted in December 2001, using a semi-structured, four-page questionnaire. PARTICIPANTS Australian hospitals with more than 10 beds. MAIN OUTCOME MEASURES Type of defibrillator; provision of CPR/defibrillation training for healthcare professionals; hospital policy as to who can use the defibrillator. RESULTS Of the 878 hospitals surveyed, 665 (76%) responded. All but one hospital indicated that CPR training was provided for nursing staff, with 12-monthly or more frequent updates; only 55% of hospitals (366) indicated that CPR training was provided for doctors. 21 of the 665 responding hospitals (3.2%) indicated that they did not have a defibrillator. 43% of hospitals had one or more defibrillators with shock advisory capacity (ie, automated external defibrillators [AEDs]). Of the 644 hospitals with defibrillators, 16% (101) indicated that registered nurses were not permitted to defibrillate; this included 9% of hospitals with AEDs. CONCLUSIONS The importance of CPR in cardiac arrest has been accepted by Australian hospitals, but the overwhelming evidence that "time to defibrillation" is the single most important determinant of cardiac arrest outcome seems less accepted. All Australian hospitals should review their resuscitation policies and practices to reflect this fact, with defibrillation by nurses, who are usually first on the scene, providing the best opportunity to minimise time to defibrillation.