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The time taken to initiate early defibrillation is crucial to improve survival, prevent neurological deficit and improve the quality of life of patients suffering from sudden cardiac arrest. Despite the extension of training and the authorization of nurses to perform early defibrillation (advocated by the American Heart Association), such practice has not been widely adopted in hospitals. Inadequate knowledge, lack of skill retention, insufficient organizational support and the passive culture of nurses are barriers preventing the move towards nurse-led defibrillation. This paper discusses the need to extend the registered nurses' role in the early defibrillation of cardiac patients in Hong Kong. Current nursing practice in emergency resuscitation care and the hurdles constraining early defibrillation will be discussed. Recommendations to facilitate the future development of nurse-led defibrillation will also be provided. The successful extension of the registered nurses' role in early defibrillation will enable them to possess broader knowledge to be clinically competent in providing efficient patient care.

Previous studies have demonstrated a high prevalence of sleep disturbance among elderly people which can exacerbate during a period of hospitalization. Whilst studies on patients' sleep experiences have largely been conducted in acute care settings, relatively little is known about the sleep experiences of elderly patients hospitalized in extended care settings. This paper aims to provide a literature review on the sleep experiences of older patients admitted into hospitals, with reference also made to studies conducted in the community in order to substantiate the existence of sleep disruptions before elderly people are admitted into hospitals. Electronic databases and specific search terms from 1980 to 2004 were used to conduct the literature search. Nurses play a crucial role in ensuring that patients get a good night's sleep and will need an in-depth understanding of older patients' sleep experiences to effectively manage different sleeping patterns and sleep needs in the clinical areas.