Table 5 Themes related to resources
From: Inhospital cardiac arrest — the crucial first 5 min: a simulation study
Theme | Facilitator | Barrier |
|---|---|---|
Knowledge | Knowledge, experience, and cognitive aids were facilitators, while lack of these was a barrier | |
A few days ago, we had a [similar event], I think it is the experience from being involved in a few situations that helped us. (Nurse 2-D28) It was good that we [two physicians] could talk about it [reversible causes]. I couldn’t remember them all, but you [physician 2-D40] had a leaflet in our pocket, which was quite good. (Physician 1-D40); I’m a junior doctor; of course, I have the leaflet. (Physician 2-D40) I think it would be nice to have an action card stating, e.g., ‘take time’. Then each person could take a card with a task. Then I would know what to do. I think that would be great. (Midwife 1-A1) | I had been here for a little while without doing anything. I had to first remember what it was I was supposed to do. (Nurse student 1-D26) I’m the ’cardiac arrest coordinator’, but the disadvantage is that I have never done it myself – I’ve always just been observing – I’m not that good in practice. (Nurse 1-A5) | |
Technical issues | Technical challenges — especially related to the alarm procedure — were a barrier | |
- | When I tried to activate the alarm, it didn’t go off on my pager. I couldn’t hear the alarm going off anywhere! (Nurse 1-B5) [Alarm system did not work in the room of the simulation] It caused some confusion when I had to go out in the hallway and shout, “hurry up”, and coordinate all that. It’s confusing, and I lost control of the situation. (Nurse assistant 1-D29) When the alarm was sounding on the phone, it took a while before I could hear that it was a cardiac arrest. I almost ended the call because I thought it was a false alarm. (Nurse 3-A1) | |
Organizational resources | Lack of resources, e.g., people or lack of skills, were a barrier. Also, limited training, training not equivalent to reality, or no training was a barrier | |
- | I didn’t think we were enough people in the beginning. I had to prioritize tasks. (Physician 1-D19) We are lots of new staff on tonight. Some of my colleagues don’t even have resuscitation training yet. (Nurse 1-D13) When we trained, we trained with just the right amount of people, and then you assume that’s what it is in a real situation. Five people: one for the AED, one to collect the equipment, one to call the cardiac arrest team, one for CPR, one to lead. (Physician 1-D26); But we were fifteen. Ten people were just standing here. (Nurse 2-D26) | |