Partnering with Consumers: Resource Critique on Cardiopulmonary Resuscitation (CPR)

CNA340: Developing professional nursing practice Semester one 2019
Partnering with Consumers: resource critique
Overview of the resource
The resource under consideration is cardiopulmonary resuscitation (CPR). Advance
form of decision making in cardiopulmonary resuscitation (Ho, Jameson & Pavlish 2016) and
its care discussions are constantly variable in regular clinical environment. Nicolas et al.
(2016) aimed to understand the physician barriers in practices of advanced decision-making
of CPR in a hospital setting and how to undertake a very pragmatic intervention (Steinmo
et
al. 2015) in order to support the clinicians and staffs to undertake the documentation for
cardiopulmonary resuscitation process in an End of Life care ((Thomas, Lobo & Detering
2017).
2 focus groups were formed of 8 consultants and 10 junior doctors, who conducted a
current literature review. The following iterative process and joint consensus was developed
into 2 distinct elementary themes: (i) an advanced ‘Goals of Patient Care’ process and goals
(ii) Educational video along incorporating teaching of the updated decision-making process
in CPR, CPR documentation and patient centred treatment plan. The multidisciplinary health
professional team and experienced policy-makers in the field of clinical development,
education and clinical research gave the analytic feedback about the literature. Through the
iterative process used in review and consultation - a video tool education along with an
updated GOPC form was developed.
Partnering with consumers and its influence of patient outcomes
The research study identified a number of barriers to the practise of CPR decision-
making. These are system and physician level barriers. The study proposed a 2-tier strategy
in order to enhance or accelerate the medical practise change in decision making process
about CPR and how the care plan drawbacks are documented in daily hospital settings. The
literature relates to structure of the integrated messages (educational) on the basis of a
joint consensus (Rossi 2018).
This was done using a video teaching tool in order to address the clinician’s barriers. The
second approach represent a mediated practise change that is through the enhancement of
the end of life care approaches- to bring decision-making rationale, treatment and care
feedback and conversations together to achieve the patient treatment goals.
The NSW policy
GL2008_018 Decisions relating to No Cardio Pulmonary Resuscitation
(CPR) Orders- is concerned with planning care for end of life patients which generally
comprises of a shift in whole focus of the care away and away from the medically planned
interventions to a more focussed patient centred palliative care approach. The guidelines
are correctly followed at Calvary.
According to Australian Commission on Quality and Safety in Health Care (ACSQHC)
National Safety and Quality Health Service Standards (NSQHS) – Healthcare organisation
leaders implement policies and environments to facilitate partnering with admitted patients,
the carers and consumers to holistically improve the quality and safety of clinical care.
Patients, consumers, caregivers and clinicians along with the clinical workforce use this
partnering system to collaborate with the consumers. The benefits associated with patient
partnered, patient-centred EOL care are – 1) decreased mortality 2) decreased hospital
readmission rates 3) minimised rates of hospital acquired infections. 4) reduced period of
hospital stay 5) enhanced adherence to clinical framework by staffs 6) improvement in
patient’s functional status.
Similarly, in this research study - the changes focus on supporting the clinical
deterioration systems in assistance of the recognition and in response to the patient
centred care and preferences. The study also aims to understand the support improvements
related to a collaborative, patient- partnered end-of-life (EOL) care. This clinical approach
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can prevent various sorts of excessive ethical burdens from the non-beneficial care plans
and interventions. Nursing training in the subject of clinical ethics, reasoning (Norman 2017)
and nursing therapeutic communication will be a vital tool in imparting the technical clinical
knowledge.
Identify how the resource meets the related ‘action’
System-wide and organization wide changes (Scott 2018) are required to support a
decision making process, in facilitating an effective handover of patients with treatment
plan document between different health professionals (with simultaneous enhancement of a
therapeutic communication) - across the healthcare settings. The research focuses in
empowering the staffs and the healthcare specialists - to drive a practise change and in
order to achieve a consensus between the different types of clinical practitioners. The
health system change, organisational culture changes (Braithwaite 2017) nursing best
practices and staff training with appropriate, accurate policy making (Dritsakis 2018) and of
course, a regular audit is crucial to normalise the clinical discussions and document the
achieved and achievable goals by the hospital admitted patients. The research study
concluded by saying that the best values and interests of patient should be the focus of a
patient centred, collaborative care. Globally, CPR based clinical models should be promoted
across all health setups to bring in a practise change in EOL care.
How effectively do you feel the resource has been implemented in your
organisation?
A proactive patient centred care supports a definitive “collaborative decision making”
in resuscitation and that is exactly what is done in my organisation – Calvary rehabilitation
hospital, but the only limitation that I faced during my placement – that there is a lack in
decision making documentation process regarding the start of EOL care. Partnering with
patients and clinical specialists is quite well undertaken at the Calvary rehabilitation but the
transformation from medical intervention to EOL care and whether to or not to use CPR
remains in grey shade and I believe, this is the area where Calvary as an organisation,
needs to take firm steps in order to glue the clinical gap.
The introduction in the advanced system of EOL care and clinical decision-making
(Johnson 2017) can be bought by education, nursing training. There is constant need for
auditing the follow-up procedure. In tandem with the educational theory (Meltzer 2018), the
research used a mixed media study to understand what complicated, intricate skills can be
acquired and then recollected from the memory base with ease.
Consider your own nursing practice
An approach too was taken to understand the physician and the organisational
barriers in implementation of progressive decision-making with CPR and CPR documentation
were determined. The incorporation of evaluative care in and across the hospital
environment, needs a precise understanding of its core principles and to determine the
effect of its application in EOL plans takes a lot of convergent efforts. I would focus on
Initiating a palliative care takes joint decision making along with the patient and patient’s
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