Learning Objective #1: Describe outcomes that patients experience after ICD implantation

Learning Objective #2: Discuss the nurse's role in teaching and providing support to patients living with an ICD

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An implantable cardioverter defibrillator (ICD) is used to treat life-threatening arrhythmias in patients at risk for sudden cardiac death. The device, while life saving, has the effect of causing disruption in recipients' lives. This technology is widespread and commonly used, but little is known about how nurses successfully intervene with patients who are receiving an ICD. A study was undertaken to identify the relationships between ICD knowledge, uncertainty, and quality of life. Theoretically, it was proposed that an unstable heart rhythm or sudden cardiac death are trigger events that would lead to increased uncertainty and decreased quality of life, which in turn would lead to a disrupted personal reality. This would be mediated by a second trigger event, implantation of the ICD and knowledge acquisition related to the device, which in turn would decrease uncertainty and increase quality of life. The results did show relationships between uncertainty and quality of life, but the role that ICD knowledge played in these relationships was less clear. For nurses in clinical practice, the implication may be that less emphasis should be placed on teaching related to the ICD, and more attention given to the broader focus of living with the device, grieving for loss of a stable heart rhythm, and celebration of having life returned by implantation of the device. This presentation will discuss these issues in the context of clinical practice, theory, and the findings of the research study.