南區某護專學生執行成人心肺復甦術之分析與探討

Evaluation of Cardiopulmonary Resuscitation Skills of Student Nurses in a Southern Nursing College

本研究之目的乃藉由評核70位南部某五專實習護生之心肺復甦術(cardiopulmonary resuscitation, CPR)技能，試圖找出多數人易犯之錯誤，以作為將來CPR教學改善的參考。評核標準分為13項，乃依據美國心臟學會(American Heart Association, AHA)公佈之準則。以新式液晶螢幕型安妮模型為工具，分別於急診室實習之第一、二、四週評估其表現，分析各項之學習進步情況與達成率。結果發現第一週並沒有人能順利完成所有評核項目，經過二週與四週的學習則分別增為1人與8人。在評核的13項要素裡，第一次評核只有「確定意識」和「求救」兩項達成率在80％以上，其餘皆低於60％。經過二週後，除了「正確按壓深度」一項之外，其餘項目在第二次評核之達成率相較於第一次皆有顯著的提高（以麥氏考驗分析，p＜ .05）。經過四週後，則所有項目在第三次評核之達成率皆明顯較第一次進步（p＜ .05）。然而，在第四週達成率中仍有過半項目未達80％，其中，「檢查脈博」、「正確按壓深度」及「每次吹氣使胸部起伏」三項之達成率甚至僅達54％至57％。綜而言之，「正確按壓深度」為護生學習上最大之障礙，不僅學習速度最慢，甚且訓練至第四週之達成率亦僅有54％。

The purpose of this study was to evaluate the cardiopulmonary resuscitation (CPR) skills of 70 student nurses in a Southern Nursing College. By identifying the most frequent mistakes made by the students, this study aimed to improve the teaching strategies of CPR skills. The 13 evaluating items were quoted from the guidelines of American Heart Association (AHA). The performance of students were tested on a digital resuscitation manikin and evaluated at the first, the second and the forth weeks in their practical training in the emergency room. The results showed that no student could accomplish all items after the first week. Only one student could complete all items after the second week. In the forth week, 8 student nurses passed all assessments. The success rates of “check responsiveness” and “call for help” reached over 80%, while the rest of the test items were below 60% in the first test. The success rates of all items were significantly improved after the second week except the “correct compression depth” (McNemar test, p < .05). Moreover, the success rates of all items in the third test were significantly improved as compared with the first test (p < .05). However, the success rates of more than half of the test items were still below 80%. The success rates of “check pulse”, “correct compression depth”, and “every inflation to produce visible lifting of the chest” ranged only 54% to 57%. In conclusion, the “chest compression” was a biggest obstacle to CPR learning with only 54% success rate after 4 weeks.