Objective: To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. Method: A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. Results: The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. Conclusion: The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units. DESCRIPTORSHeart Arrest; Cardiopulmonary Resuscitation; Emergency Nursing; Impatient Care Units.Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses* Fatores que comprometem a qualidade da ressuscitação cardiopulmonar em unidades de internação: percepção do enfermeiro Factores que comprometen la calidad de la reanimación cardiopulmonar en unidades de estancia hospitalaria: percepción del enfermero
Background:The results of studies regarding the relationship between length of stay of patients in emergency departments (EDs) and mortality in intensive care units (ICUs) are contradictory, and nothing is known about the impact of delayed admission of patients to ICUs on nursing workload. Aims and Objectives: To assess the influence of the time lapse between ED and ICU admissions on mortality and nursing workload in relation to intensive care patients. Design: This was a retrospective cohort study that examined the medical records of patients who were 15 years of age or older and admitted directly to the ICU from the ED. Methods: The data were collected between 2014 and 2016 in a hospital located in São Paulo, Brazil. Nursing workload was measured by the Nursing Activities Score. Multiple linear and logistic regressions were applied, with a significance level of 5%. Results: Of the 534 patients analysed, the majority were men (57⋅49%); the mean age was 55⋅37 ± 19⋅64 years. Length of stay in the ED was not associated with nursing workload at the time of admission of patients to the ICU or during their stay in the unit. For mortality, this variable was a risk factor along with cause of admission, length of stay in the ICU and the Simplified Acute Physiology Score 3 score. For every additional hour that patients remained in the ED, their chance of dying in the ICU increased by 1%. Conclusion: Length of stay of patients in the ED was a risk factor for mortality in the ICU; however, this variable did not have any influence on nursing workload. Relevance to clinical practice: Strategies need to be implemented to optimize the availability of ICU beds and reduce the length of stay of critical patients in the ED as delays in admitting such patients to the ICU have an impact on mortality.
Summary Mortality and morbidity for high‐risk surgical patients are often high, especially in low‐resource settings. Enhanced peri‐operative care has the potential to reduce preventable deaths but must be designed to meet local needs. This before‐and‐after cohort study aimed to assess the effectiveness of a postoperative 48‐hour enhanced care pathway for high‐risk surgical patients (‘high‐risk surgical bundle’) who did not meet the criteria for elective admission to intensive care. The pathway comprised of six elements: risk identification and communication; adoption of a high‐risk post‐anaesthesia care unit discharge checklist; prompt nursing admission to ward; intensification of vital signs monitoring; troponin measurement; and prompt access to medical support if required. The primary outcome was in‐hospital mortality. Data describing 1189 patients from two groups, before and after implementation of the pathway, were compared. The usual care group comprised a retrospective cohort of high‐risk surgical patients between September 2015 and December 2016. The intervention group prospectively included high‐risk surgical patients from February 2019 to March 2020. Unadjusted mortality rate was 10.5% (78/746) for the usual care and 6.3% (28/443) for the intervention group. After adjustment, the intervention effect remained significant (RR 0.46 (95%CI 0.30–0.72). The high‐risk surgical bundle group received more rapid response team calls (24% vs. 12.6%; RR 0.63 [95%CI 0.49–0.80]) and surgical re‐interventions (18.9 vs. 7.5%; RR 0.41 [95%CI 0.30–0.59]). These data suggest that a clinical pathway based on enhanced surveillance for high‐risk surgical patients in a resource‐constrained setting could reduce in‐hospital mortality.
Objective: To evaluate the effectiveness of a cardiopulmonary resuscitation training in the skill acquisition of family members of heart disease patients. Method: A quasi-experimental study, conducted in a hospital in São Paulo, Brazil. The study participants were one or more relatives of patients with heart disease that were hospitalized at the institution. In the first phase, the participant’s skills and theoretical knowledge on cardiopulmonary resuscitation were evaluated before and immediately after the training. The second phase took place one month after the training, in which the same evaluations were applied. The McNemar’s and Stuart-Maxwell tests were adopted (5% significance level). Results: The theoretical knowledge of family members before and after training increased and a great retention of this knowledge after 30 days of training was observed. Immediately after training, the family members showed significant improvement of skills in the 15 analyzed actions and, after one month of training, they maintained most of the acquired practices on cardiopulmonary resuscitation, except for chest compressions frequency and the time between turning on the defibrillator and delivering the shock. Conclusion: Cardiopulmonary resuscitation training was effective in the acquisition of theoretical and practical knowledge of the family members.
RESUMO Objetivo: Avaliar a efetividade de um treinamento sobre ressuscitação cardiopulmonar na aprendizagem de familiares de pacientes cardiopatas. Método: Estudo quase experimental, realizado em hospital de São Paulo, Brasil. Participaram da pesquisa um ou mais familiares de pacientes cardiopatas internados na instituição. Na primeira fase foram avaliados o conhecimento teórico e as habilidades dos participantes sobre a ressuscitação cardiopulmonar antes e imediatamente após o treinamento. A segunda fase aconteceu um mês após o treinamento, com a aplicação das mesmas avaliações. Os testes McNemar e Stuart-Maxwell foram adotados (nível de significância de 5%). Resultados: Houve aumento do conhecimento teórico dos familiares antes e após o treinamento e elevada retenção desse conhecimento após 30 dias da capacitação. Os familiares apresentaram, após o treinamento, melhora significativa das habilidades nas 15 ações analisadas e, após um mês da capacitação, mantiveram a maioria das práticas assimiladas sobre ressuscitação cardiopulmonar, com exceção da frequência das compressões torácicas e do tempo entre ligar o desfibrilador e aplicar o choque. Conclusão: O treinamento sobre ressuscitação cardiopulmonar foi efetivo na aprendizagem teórica e prática dos familiares.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.