Objectives: The purpose of an integrative literature review was to identify signs and symptoms that precede acute cardiac deterioration within a critical care setting, and to establish a new recognition protocol to ameliorate patient care outcomes. Cardiac deterioration is a major public health problem with over 350,000 in-hospital cardiac arrests happening each year in the United States (American Heart Association, 2016). Nurses need to be better educated on the signs and symptoms that antecede a cardiac arrest, and have a protocol to identify and to initiate intervention.
Method: An integrative literature review was conducted undergoing an extensive integrative search to identify acute cardiac deterioration within a critical care setting and recognizing protocol measures. Whittemore and Knafl’s (2005) approach to amalgamate review writing was used as a framework to synthesize and organize the literature found.
Results: Vital signs, level of consciousness, lab values, EKG, and age were found to be the most supported symptoms, which lead to acute cardiac deterioration within a critical care setting (Soar & Subbe, 2012; Hodgetts, et al, 2006; Preece et al., 2012). It is unknown if the the current protocols for nurses to recognize these signs are effective in treating patients. Recommendations for a new protocol include the development of an early warning score system.
Conclusions: This review found five clinical symptoms related to cardiac deterioration; however, these symptoms in current nursing protocol programs are not well addressed. Thus, there is a need to develop an appropriate prevention program incorporating these symptoms to help decrease the risk for cardiac deterioration with the intensive care unit.
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