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Essay on cardiopulmonary resuscitation
Family presence during resuscitation essay
Essay on cardiopulmonary resuscitation
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Introduction
Family presence during cardiopulmonary resuscitation (FPDR) has been a controversial topic in hospitals for years. Having family at the bedside during a traumatic event can either be beneficial or detrimental to the staff and family which is why research is essential to determine if family should be at the bedside. There are pros and cons to having a family member present during life saving events. Cardiopulmonary resuscitation (CPR) is an emergency procedure for manually preserving brain function until further measures to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest (Merriam-Webster, 2014).
In the past families were not allowed in the room during resuscitation because there were concerns that procedures could be too traumatic for the families and could cause liability issues for the institution. This paper will focus on staff and families thoughts and views on having family in the room during CPR. This review will have background information about FPDR including a systematic review (Howlett & Tsuchiya, 2010), a meta-analysis (Madden, 2014), two qualitative studies on nurses and families thoughts on being present during CPR (Meyers & Eichhorn et al., 2008) (Knott & Kee, 2009), and two quantitative studies (Condon, 2010), (Porter & Sellick et al., 2013) and will conclude on the existing best practice at this point in time. FPDR has benefits and disadvantages with countless studies and surveys concerning this.
Background
CPR was not developed before 1950 so people that went into cardiac arrest would die, no measures were set in place to save them and family members would just accept this as part of the life cycle (Doolin, Quinn, Bryant, Lyons, & Kleinpell, 2011)....
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...arch sample sizes ranged from 51 to 984 people and included nurses, doctors, family members and the general public. Two studies used a phenomenology approach and concentrated on the opinions of only emergency nurses. Two studies interviewed 78 family members using a RCT approach. The RCT found that no respondents felt pressure to be present, however 43% preferred to be in the room. In the control group or 200 people, 64% of respondents stated that they would prefer to be present and 100% of those respondents that were present were glad that they were present (Holzhauser et al., 2006). This article was extremely helpful for this best practice because it summarized all data using quantitative, qualitative and randomized control tests. It provided great information and a large overview of the topic; this was the most helpful article during this research.
Qualitative
Although we haven't covered these systems in detail yet, which of the following systems would involve gas exchange of CO2 and O2?
...the patient’s family more within the assessment after obtaining the patients consent, but my main aim in this case was to concentrate the assessment, solely on the patient, with little information from the family/loved ones. This is a vital skill to remember as patients family/loved ones can often feel unimportant and distant toward nursing staff, and no one knows the patient better than they do, and can tell you vital information. Therefore involvement of family/ carers or loved ones is sometimes crucial to patient’s further treatment and outcomes.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
Despite the fact that from May 2009 - February 2010, in Contra Costa County alone, there were 9 sudden cardiac arrests experienced by children and youth, there is no standard curriculum in place at school for youth and their parents to learn lifesaving CPR skills. The youngest was 10 years of age and the oldest was 17, which resulted in 4 deaths and 5 saved lives (Darius Jones Foundation, 2011). In each case, there was a direct correlation between bystander use of cardio-pulmonary resuscitation (CPR) and those children who survived.
Nobody is perfect. We all make mistakes. Some of the best lessons in life are learned from making a mistake. But in the healthcare world making mistakes means losing lives. This has started to happen so frequently there has been a term coined – Failure to Rescue or FTR. Failure to rescue is a situation in which a patient was starting to deteriorate and it wasn’t noticed or it wasn’t properly addressed and the patient dies. The idea is that doctors or nurses could’ve had the opportunity to save the life of the patient but because of a variety of reasons, didn’t. This paper discusses the concept of FTR, describes ways to prevent it from happening; especially in relation to strokes or cerebrovascular accidents, and discusses the nursing implications involved in all of these factors.
Two potential barriers to the Patient-Family Centered Care model are time and patient/family expectations. Nursing is a demanding job that is known for it's fast paced and often hectic environment. While caring for several patients at a time, it might be difficult to make time to discuss and involve patients and their family in all aspects of their care. This could lead to the patient/family feeling left out or even lead to fear about why information if being kept from them. To address this barrier I will set aside time to spend with each of my patients solely dedicated to discussion about the care they are receiving as well as provide an opportunity to voice questions and concerns.
Treating the patient and family as one, can have improved outcomes, decrease hospital stays, increased patient satisfaction, and improved reimbursements for the hospital. Developing a relationship with not only the patient, but family as well, can pay off in the long run by providing better communication, better quality of care, and trust. The patient and family can be strong advocates for improved performance improvement efforts. Including family in the treatment of the patient treats the “whole” patient through their hospitalization. Involving the family can enhance the patients care.
According to the American Heart Association (AHA), over 350,000 people experience cardiac arrest outside of hospitals every year. Every second that a heart doesn’t beat dramatically decreases a person’s survival rate. CPR is a simple way to keep blood pumping through the body until medical personnel arrive. Only 46 percent of cardiac arrest victims receive CPR, primarily because most bystanders don’t have the proper training. Fortunately, schools are in a unique position to greatly improve that statistic.
Quantitative Research Article Critique This paper is an academic critique of an article written by Lautrette, et al. (2007) titled: “A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU” and accurately reflected the content of the article and the research study itself. The abstract explains the article in more detail, while remaining concise.
Participant 4 stated, “I think just basically being there for the family as well…I think even just a cup of tea can go a long way with any family (McCallum & McConigley, 2013). Another theory that intertwines with Watson’s is Barbara Dossey’s Theory of Integral Nursing. Dossey articulates, “Healing is not predictable, it is not synonymous with curing but the potential for healing is always present even until one’s last breath,” (Parker and Smith, 2015, p. 212). Dossey believes that integral nursing is a comprehensive way to organize different situations in fours perspectives (nurse, health, person and environment) of reality with the nurse as an instrument in the healing process by bringing his or her whole self into a relationship with another whole self. In the HDU, the RN’s interacted with each patient while providing high quality care to create a healing environment for the patient and family even when their prognosis was otherwise. Patient 3 specified that “We still have to provide care...and make the family feel that they are comfortable and looked after” (McCallum & McConigley, 2013). These theories ultimately show the importance of a nurse through the aspects of caring to create and maintain a healing environment that is not only beneficial to the patient but to their loved ones as
Wall, Y., & Kautz, D. (2011). Preventing sentinel events caused by family members. Dimensions of Critical Care Nursing, 30(1), 25-27. doi: 10.1097/DCC.0b013e3181fd02a0
With the establishment of the DNR order, withholding CPR from an individual has reformed into standing as “ethically appropriate if the anticipated benefit outweighs the harm. However, since then, the literal meaning of DNR has not been clear, thus causing confusion that remains problematic in clinical practice” (Yen-Yuan 4). With the renovation of the DNR order, people and health care providers have worked to progress defining what the DNR order stands for along with people gaining autonomy in their choice of death. Additionally, associations and activists keep pushing forward in the refinement of the DNR order: “there has been increasing focus on promoting quality of care for the dying [. . .] However, the persistent problems with DNR orders suggest that physician behaviors toward communication with patients about goals of care and resuscitation decisions have not measurably changed in the past 20 years” (Yuen 7). Through the efforts of benefactors such as the American Heart Association and others, the DNR order will continue to increase in quality over time as improvements are made. The DNR order sprouted from the first incentives that people deserve a say in how they shall die and today has transformed into a necessity that functions to entitle people to their own choice of death or
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.
Aidan is currently 3 years old and lives with his mother, father, and older brother. His mother, Andrea, age 23, is currently enrolled at the University of North Carolina at Greensboro (UNCG) and is working to get her Bachelors degree in elementary education. During the afternoon, she works at The Children’s Center of Asheboro as a second shift teacher for 3-4 year olds. His father, Rene, 24, is also enrolled at UNCG and is working to get a bachelor’s degree in computer science. He also has a job; he works at Dunham’s in Asheboro. Aidan’s parents have been together for 8 years, and have lived together for 7 years. Although they have lived together for 7 years, they are not married. This CPR report was developed by using the Family-Focused Interview Questionnaire with Aiden’s mother, Andrea.
The American Heart Association states that the goals of cardiopulmonary resuscitation are, “to preserve life, restore health, relieve suffering, limit disability, and respect the individual’s decisions rights and privacy” (AHA Guidelines for CPR). The practice of offering family members the opportunity to be present during CPR is a controversial ethical issue in emergency medical services. While the results of the study published on this topic in The New England Journal of Medicine clearly show no negative side effects from having families present during resuscitation attempts, the limitations of the study lend to the need for more research before it could be universally accepted.