The survival rates of cardiac arrest patients

The survival statistics of cardiac arrest patients in hospitals continue to be dismal. Although nurses frequently respond to such arrests, limited training may cause first responders to wait for an innovative Cardiac Life supporting and trained professionals in order to provide the finest performing defibrillation. In this situation, it will be required to determine whether the survival rate increases or decreases if a single person does chest compression as opposed to chest compression with rescue breath. To improve the chances of survival during chest compression, various automatic external defibrillators designed for use by nurses must be introduced. Studies have however established that the use of these AED results to lower rates of survival especially when one acquires in-hospital cardiac arrest as compared lack of using AED (Yeung, Meeks, Edelson, Gao, Soar & Perkins, 2009). These unexpected results are mainly acquired after interruptions to the cardiopulmonary recovery during the AED advisory mode. It is the responsibility of the nurses to find out some of the best practices that can be used in study that is important to the nursing practice through the use of meaningful practices.

The Primary intention of this research is to establish a practice issue (In cardiac arrest patients receiving CPR) explaining how to solve the issue within the nursing practice, developing some five research questions which pertain the problem, developing the feasibility of every question, framing a PICOT question and finally stating some key words which can be utilized while conducting a literature research.

Background Questions and Analyses of Feasibility

According to Polit & Beck, it is the responsibility of a researcher to formulate some background questions that are broad which can lead to the key research problem after identifying the question (Polit & Beck, 2008). It is necessary to ensure that every formulated question is relevant to the issue as well as feasible. Feasibility, in this case, helps in considering the time of the study, the availability of the research participants, equipment and facilities, ethical considerations within the study, equipment and facilities used in the study and the cooperation of people within the research. The key background questions for our research are as stated below:

What is the most effective process of an efficient CPR?

What are the main barriers to implementing CPR?

How can nurses involve the patient and the family in CPR?

Should Nurses perform CPR with Chest Compression Alone or With Rescue Breathing and in a timely manner?

It is evident that out of hospital cardiac arrest can claim the lives of thousands of people within a year in the entire world. It is, however, challenging to get successful resuscitation but it can, however, be achieved. An interdependent action is therefore required which consists of timely arrest identification, early post-resuscitation observation, timely defibrillation and timely cardiopulmonary resuscitation (CPR) (Yeung, Meeks, Edelson, Gao, Soar & Perkins, 2009). It is necessary to ensure that there is a timely initiation of CPR by a layperson so as to increase the chances of survival for a patient. It is also necessary to have some suitable long-term neurologic recovery in this case. The CPR that is performed by a Layperson has always contained chest compressions intermingled with rescue breathing traditionally. This kind of CPR always allows better measures to take place for oxygenation and circulation. The key interest in CPR mainly seeks to determine whether chest compressions can be minimized or whether the elimination of rescue breathing will continue to increase. I suggest that chest compression is more acceptable to various laypersons and is capable of improving the physiological advantage of lesser compression interruptions in order to improve circulation that is compared to the traditional CPR at an improved oxygenation.

Most of the research from animal models involving primary cardiac arrest as well as fake encounters to laypersons who perform CPR show that there is an increase in circulation as well as the improved potential of survival through chest compression only (Ritter, Wolfe, Goldstein, Acheson & Medendrop, 1985). On the other hand, it is evident that the animal models that receive cardiac arrest because of causes from respiratory issue show that chest compression, as well as rescue breathing, can be more helpful. The comparison of CPR trials, in this case, does not bring any differences between patients with chest compression only but those with compression as well as breathing appears to be relevant in the clinical situation and the percentage is 15% vs 11.5%.

From our research, it is necessary to initiate CPR early so as to reduce the costs for the learning tools required by the nurses. It is necessary to have chart audits and survey for every week that will be filled by the nurses and the patients from every category. It is necessary to utilize some ethical considerations in this research if the research participants who are patients do not require any aspect of their history to be understood in the family member present.

PICOT Question

In order to find a suitable evidence, it is necessary for the nurses to frame a clinical question in a strategic manner. The term PICOT is used in identifying the population, intervention, comparison, outcome and time as related to a clinical question (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). From the research I formulated the following question: In Cardiac arrest patients receiving CPR (P), Is the survival rate increased or decreased (I) if a single person rescuer pre-forms on chest compression (Chest compression fraction) (C) compared to the 30:2 chest compression and rescue breath (O), within the first few minutes (T)?

Main Words Used in Literature Research.

It is necessary to consider the kind of database that can yield some sufficient results as well as the level of the pyramid that comes up with suitable results. Some of the primary words that will assist in guiding the research of information regarding the question include Cardiac arrest reports, shifting reports, handoff reports, satisfaction, patient safety and the report on SBAR (Patient situation, satisfaction, background assessment and recommendation) (Grove, Burns & Gray, 2012). It will be necessary to keep the keywords broad while performing a research in the filtered database. In this case, most of the keywords utilized did not provide suitable or matching results from the filtered databases. Most of the keywords however generated better results from the unfiltered databases of the hospital. The results were however irrelevant to our study.

Conclusion

CPR instructions which consist of chest compression only do not increase the rate of survival in the hospital discharge only while compared to the instructions which include chest compression and rescue breathing. Research, however, suggests that chest compression only can improve the survival among various patients especially those who have cardiac arrest and those experiencing ventricular fibrillation, Nurses face various challenges while being in the healthcare department most of which can be improved through the utilization of evidence based research. Nurses can choose to remain proactive and ensure that they remain familiar with how they access suitable literature. Nurses can also choose to become the primary changing agents of a situation. Employing suitable Cardiac arrest treatment will result in quality, safe as well as effective delivery of care to patients in this situation.

References

Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal, synthesis, and generation of evidence. Elsevier Health Sciences.

Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.

Ritter, G., Wolfe, R. A., Goldstein, S., Landis, J. R., Vasu, C. M., Acheson, A., ... & Medendrop, S. V. (1985). The effect of bystander CPR on the survival of out-of-hospital cardiac arrest victims. American heart journal, 110(5), 932-937.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. AJN The American Journal of Nursing, 110(3), 58-61.

Yeung, J., Meeks, R., Edelson, D., Gao, F., Soar, J., & Perkins, G. D. (2009). The use of CPR feedback/prompt devices during training and CPR performance: a systematic review. Resuscitation, 80(7), 743-751.