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Thursday, 15 July 2010: 4:25 PM
Learning Objective 1: The learners would be able to identify association between early warning signs and incidence of cardiopulmonary arrest in surgical patients
Learning Objective 2: The learners would be able to identify measures to reduce cardiopulmonary arrests and improve outcomes of post cardiac arrest patients
Studies conducted in last few decades show little evidence that the in hospital mortality rate of patients who achieve return of spontaneous circulation after cardiac arrest has changed significantly in past half century. Considering poor clinical outcomes of patients post cardiac arrest, organizations are moving towards the notion of preventing cardiopulmonary arrests through early identification and timely management of clinical emergencies. Towards this safety mission of reducing the codes, quality circle was initiated in 2 surgical units during period of Jan- Dec 2008 at Aga Khan University Hospital.
Diagnostic journey included retrospective and prospective evaluation of codes to identify common causes of cardiac arrest, pre arrest vitals deteriorations, nursing assessment and clinical management and outcome of patients. Findings revealed that common causes of cardiopulmonary arrest in post surgical patients included shock, respiratory failure and intracranial hypertension and aspiration. In all cases significant vital deterioration was noticed atleast 6 hours prior to cardiac arrest, which was either not identified or managed inadequately.
Remedial journey was 2 fold. Primary focus was to improving nursing risk assessment for early identification of warning signs. Second aim was competency development of nurses towards management of common post surgical emergencies leading to cardiopulmonary sequel through clinical mentorship, critical care nursing outreach service, reflective practice and case based learning.
Early identification and timely management of medical emergencies caused 42% reduction in number of codes in post surgical patients after 6 months of interventions. Codes per thousand discharges also dropped down from 5.4/1000 discharges to 3.09/1000 discharges. And the survival outcome of post arrest patients significantly improved from 5.26% to 27.27% in post surgical patients.
Diagnostic journey included retrospective and prospective evaluation of codes to identify common causes of cardiac arrest, pre arrest vitals deteriorations, nursing assessment and clinical management and outcome of patients. Findings revealed that common causes of cardiopulmonary arrest in post surgical patients included shock, respiratory failure and intracranial hypertension and aspiration. In all cases significant vital deterioration was noticed atleast 6 hours prior to cardiac arrest, which was either not identified or managed inadequately.
Remedial journey was 2 fold. Primary focus was to improving nursing risk assessment for early identification of warning signs. Second aim was competency development of nurses towards management of common post surgical emergencies leading to cardiopulmonary sequel through clinical mentorship, critical care nursing outreach service, reflective practice and case based learning.
Early identification and timely management of medical emergencies caused 42% reduction in number of codes in post surgical patients after 6 months of interventions. Codes per thousand discharges also dropped down from 5.4/1000 discharges to 3.09/1000 discharges. And the survival outcome of post arrest patients significantly improved from 5.26% to 27.27% in post surgical patients.
See more of: Post-Surgical Nursing Implementations
See more of: Evidence-Based Practice Sessions – Oral Paper & Posters
See more of: Evidence-Based Practice Sessions – Oral Paper & Posters