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Learning Objective 1: Determine physiological variables that can identify patient at risk for cardiopulmonary arrest (CPA).
Learning Objective 2: Understand the role of the nurses in preserving physiological safety by early recognition and correction of physiological abnormality in preventing cardiopulmonary arrest
Cardiopulmonary arrest is a life-threatening event that requires rapid identification and intervention to prevent cardiopulmonary arrest (CPA). Despite the advances in medical technology and in cardiopulmonary resuscitation the mortality of in-hospital cardiac arrest has remained largely static at 50-80% (Buist, Moore, Bernard, Waxman, Anderson, Nguyen, 2002). Many of these adverse events are preventable and are preceded by a period during which the patient exhibits clearly abnormal physiological signs. Several studies indicate that up to 80% of patient's suffering from CPA has signs of physiological instability; basically there is an alteration in the commonly measured vital signs in the 24 hours prior to arrest. In the acute care setting, nurses are in the best position to early recognize the signs of physiologic instability and intervene before an arrest occurs. The role of the nurses in preserving physiological safety by early recognition and correction of physiological abnormality is a key factor in preventing CPA. Early recognition and interventions by medical personnel would help to decrease the mortality related to CPA.
Method
Retrospective, chart review of all adult patients admitted in the intensive care unit (ICU) and special care unit (SCU), who had CPA.
Results: out come of this retrospective study of 100 patients reveals that out of 100 patients who had in-hospital CPA, 66% of patients died, 26% of patients revived and 8% of patients had anoxic brain injury after CPA. T-test of independent sample reveled that there is a significant differences in the systolic BP 1 hour before arrest and in GCS 6 hours and 12 hours before arrest.
A module was developed to train the nurses about early warning signs (EWS). A prospective study is required to see the impact of educational training to staff nurses on patients out come.
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