NUR 590 Evidence Based Practice Project Week 3 Discussion
DQ1 What levels of evidence are present in relation to research and practice, and why are they important regardless of the method you use?
Will educating nurses to perform continuous compression during defibrillation with no shock pauses for patients in cardiac arrest increase the likelihood of spontaneous recovery? The most recent guidelines emphasize the importance of performing chest compressions at an appropriate rate and depth, with complete recoils and minimal pauses (Luo et al., 2021). Because of this, pauses during resuscitation can exceed the recommended guidelines of 5-10 seconds during defibrillation. Charging defibrillators before analyzing heart rhythms may reduce no-flow time during rhythm check pauses during cardiac arrest resuscitation (Kemper et al., 2019). High-quality chest compressions have been identified as a key determinant of successful resuscitations (Luo et al., 2021). Mechanical chest compressions can be provided by devices such as the LUCUS device, allowing for continuous compressions to occur during shock administration. Educating
nurses on the importance of continuous uninterrupted compressions may help eliminate or shorten prolonged pauses during resuscitation efforts. In addition, educating nurses about technologies available to help decrease pauses during resuscitation, ultimately improving patient outcomes by increasing perfusion.
This topic is important to continue research being that the American Heart Association has recently emphasized compressions as the first response action for patients in cardiac arrest. Compressions allow for perfusion, giving the patient the best chance for survival. As an Emergency Department nurse it is virtual, the pauses are kept to a minimum and human error is eliminated to the best of our ability. Human errors such as equipment malfunctions, equipment use, and overall knowledge that defibrillation can occur simultaneously during compressions are all factors that can affect a patient’s outcome.
I anticipate problems with the proposed implementation of my project, including financial difficulties. My research focuses on the importance of continuous CPR during defibrillation. For many decades, the focus of CPR was on airway, breathing, and circulation. The American Heart Association recently announced that circulation would be prioritized over cardiopulmonary resuscitation (American Heart Association., n.d.). This means that early and continuous high-quality compressions have been shown to improve circulation and perfusion during CPR, thereby improving patient outcomes. Interruptions in chest compressions lasting more than 10 seconds, according to Clark et al., 2019, are associated with poor outcomes: “previous literature has associated shorter peri-shock pause times with greater odds of survival and longest pause during chest compressions with lower odds of survival” (Clark et al.,2019). Getting physicians and nurses on board with the new evidence-based practice is a major impediment to implementation. It is extremely difficult to change people’s habits, particularly if they have been doing so for a long time. A significant amount of education and support from leadership, as well as clinical education, will be required to encourage staff buy-in to this new practice. Furthermore, simulation studies revealed that ECG devices and the LUCUS device were the most beneficial for performing continuous compressions during defibrillation. These devices are extremely expensive and may be beyond the financial means of small rural community hospitals. Due to a lack of funding, small community hospitals will be unable to provide patients with the most up-to-date evidence-based practice care. This is not only a barrier to implementation, but it is also a barrier to providing the best possible care to the patient.
Also Check Out: NUR-550 Literature Review – Resubmission
The articles share a common aspect that entails approaches to reducing and preventing the occurrence of HAIs. The articles are also similar because their focus is to enhance patient safety and improve the quality of care. The articles also emphasize the need for healthcare workers to apply evidence-based interventions in mitigating hospital acquired infections. A majority of the articles use systematic reviews to show the various interventions based on evidence that can enhance quality care and lead to reduced chances of adverse medical events. A systematic review allows one to assess evidence from multiple sources to attain validity and reliability of their findings. The articles also have similarities as they make effective review of literature to demonstrate that HAIs are a public health concern but healthcare workers, particularly nurses, can develop EBP measures to enhance hand hygiene practices and embrace effective interventions. The articles share a common aspect of hand hygiene and other associated components that can lead to a reduction of HAIs).
The main themes of the article include hygiene, handwashing, need for patient safety and use of translational research and evidence-based project interventions for improved patient care and quality. The articles use different methods as some are systematic reviews while others are primary studies on their respective subjects. The articles have a common conclusion that stakeholders should develop more interventions to reduce and prevent HAIs, especially the use of evidence-based practice interventions. Each article has its unique limitations. However, a majority identify the need for more resources for better research studies in the future on how to prevent HAIs. No controversies exist in the article as in each, the researchers followed set guidelines to enhance validity and reliability of their findings.
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