Monitoring in the Peri-Cardiopulmonary Arrest Period and During Cardiopulmonary Resuscitation at an Emergency Department

Authors

  • Tossaporn Putchakam Faculty of Nursing, Chiang Mai University
  • Achara Sukonthasarn Faculty of Nursing, Chiang Mai University
  • Suparat Wangsrikhun Faculty of Nursing, Chiang Mai University

Keywords:

Monitoring, Cardiopulmonary arrest, Emergency department

Abstract

Accurate and appropriate monitoring of patients in the emergency department is crucial for nurses’ timely detection of a patient’s changing condition so they can receive prompt treatment. This descriptive retrospective study aimed to explore nurses’ monitoring in the peri-cardiopulmonary arrest period and during cardiopulmonary resuscitation at an emergency department. Samples included 92 medical records of resuscitation patients who received cardiopulmonary resuscitation at an emergency department. The research instrument was the Nurses’ Monitoring in the Peri-Cardiopulmonary Arrest Period and During Cardiopulmonary Resuscitation at an Emergency Department Data Record Form, which was developed by the researcher based on Pothitakis and others’ framework (Pothitakis et al., 2011) and the literature review. The record form was checked for its content validity by five experts. The inter-rater reliability between the researcher and experts was conducted and yielded a reliability of 1.00.

Data were analyzed using descriptive statistics.

 The results of this study revealed that only 17.4% of monitoring in the peri-cardiopulmonary arrest period met the monitoring criteria. None of the samples received monitoring during cardiopulmonary resuscitation which was consistent with the monitoring criteria.

The findings of this study demonstrate the need to improve the monitoring of patients done by nurses in the emergency department. Accurate and appropriate monitoring of patients will allow nurses to deliver quality nursing care.

Downloads

Download data is not yet available.

References

Adane, K., Muluye, D. & Abebe, M. (2013). Processing medical data: A systematic review. Archives of Public Health, 71(27), 1-6. doi:10.1186/0778-7367-71-27

Agency for Health Care Research and Quality. (2011). Emergency Severity Index (ESI) a triage tool for emergency department care version 4 implementation handbook. Gaither Road Rockville, MD: Author.

Agency for Health Care Research and Quality. (2014). Early warning scoring system proactively identifies patients at risk of deterioration, leading to fewer cardiopulmonary emergencies and deaths. Retrieved from http://www.innovations.ahrg.gov/content.aspx?id=2607

American Heart Association. (2014). About cardiac arrest. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About-Cardiac-Arrest_UCM_307905_Article.jsp

Australian Resuscitation Council & New Zealand Resuscitation Council. (2011). Protocols for adult advance life support. ARC and NZRC guideline 2010. Emergency Medicine Australasia, 23(3), 271-274. doi: 10.1111/j.1742-6723.2011.01422_10.x

Bortle, C. D. & Levitan, R. (2016). Overview of respiratory arrest. Retrieved fromhttp://www.merckmanuals.com/professional/critical-care-medicine/ respiratory-arrest/overview-of-respiratory-arrest

Canadian Association of Emergency Physicians – CAEP. (2014). Implementationguidelines. Retrieved from http://caep.ca/resources/ctas/implementation-guidelines#goals-of-triage

Deakin, C. D., Nolan, J. P., Soar, J., Sunde, K., Koster, R. W., Smith, G. B., & Perkins, G. D. (2010). European resuscitation council guidelines for resuscitation 2010 Section 4: Adult advance life support. Resuscitation, 81(10), 1305-1352. doi: 10.1016/j.resuscitation.2010.08.017

Howes, D., Gray, H. S., Brooks, C. S., Boyd, G. J., Djogovic, D., Golan, E., … Muscedere, J. (2016). Canadian guidelines for the use of targeted temperature management (therapeutic hypothermia) after cardiac arrest: A joint statement from the Canadian Critical Care Society (CCCS), Canadian Neurocritical Care Society (CNCCS), and the Canadian Critical Care Trials Group (CCCTG). Resuscitation, 98, 48–63. doi:10.1016/j.resuscitation.2015.07.052

Institute for Healthcare Improvement. (2014). Early warning systems: Scorecards that save lives. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/EarlyWarningSystemsScorecardsThatSaveLives.aspx

Johnson, K. D., Winkelman, C., Burant, C. J., Dolansky, M., & Totten, V. (2014). The factors that affect the frequency of vital sign monitoring in the emergency department. Journal of Emergency Nursing, 40(1), 27-35. doi: org/10.1016/j.jen.2012.07.023

Källberg, A, Göransson A. C. E. K., Florin d. J., Östergren, J., Brixey, J. J., & Ehrenberg, A. (2015). Contributing factors to errors in Swedish emergency departments. International Emergency Nursing, 23, 156–161. doi: org/10.1016/j.ienj.2014.10.002

Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., … Wilson, J. A. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7), doi:10.1161/STR.0000000000000024

Kyriacos, U., Jelsma, J., James, M., & Jordan, S. (2014). Monitoring vital signs: Development of a modified early warning scoring (Mews) system for general wards in a developing country. PLOS one, 9(1), 1-10. doi: 10.1371/journal.pone.0087073

Linden, M., C, Barbara, E. A, M. & van der Linden N. (2016). Emergency department crowding affects triage processes. International Emergency Nursing, 29, 27–31. doi: org/10.1016/j.ienj.2016.02.003

Neumar, R. W., Otto, C. W., Link, M. S., Kronick, S. L., Shuster, M., Callaway, C. W., … Morrison, L. J. (2010). Part 8: Adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 122(18 Suppl 3), s729-s767.doi:10.1161/CIRCULATIONAHA.110.970988

Patocka, C., Turner, J., Xue, X., & Segal, E. (2014). Evaluation of an Emergency Department Triage Screening Tool for suspected severe sepsis and septic shock. Journal for Healthcare Quality, 36, 52-61.

Peberdy, M. A., callaway, C. W., Neumar, R. W., Geocadin, R. G., Zimmerman, J. L., Donnino, M., … Kronick, S. L. (2010). Part 9: Post-cardiac arrest care: 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 122(18 Suppl 3), s768-s786. doi: 10.1161/CIRCULATIONAHA.110.971002

Pothitakis, C., Ekmektzoglou, K. A., Piagkou, M., Karatzas, T., & Xanthos, T. (2011). Nursing role in monitoring during cardiopulmonary resuscitation and in the peri-arrest period: A review. Heart & Lung, 40(6), 530-544. doi: 10.1016/j.hrtlng.2010.11.006

Roffi, M., Patrono, C., Collet, J., Mueller, C., Valgimigli, M., Andreotti, F., … Windecker, S. (2016). 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal, 37(3), 267–315. doi: 10.1093/eurheartj/ehv320

Smith, G. B. (2010). In-hospital cardiac arrest: Is it time for an in-hospital ‘chain of prevention? Resuscitation, 81(9), 1209-1211. doi: 10.1016/j.resuscitation.2010.04.017

Travers, H. A., Rea, D. T., Bobrow, J. B., Edelson, J. B., Berg, P. D., Sayre, R. M., … Swor, A. R. (2010). Part 4: CPR overview: 2010 American Heart Association Guideline for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 122(18 Suppl 3), S676-s684. doi: 10.1161/CIRCULATIONAHA.110.970913

Thana, K., & Klunklin, A. (2015). Nursing documentation: The nurses’ most importantevidence. Nursing Journal, 42(1), 164-170.

Published

2022-09-21

Issue

Section

Research Article