Evidence Based Research Nursing

EVIDENCE BASED RESEARCH 1
Evidence Based Research Nursing
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EVIDENCE BASED RESEARCH 2
Evidence-Based Research Nursing
A1. Summary
The healthcare problem under study regards the effectiveness of the use of modern CPR
devices versus the use conventional chest compression CPR technique in preventing mortality
amongst hospitalized adults under cardiac arrest. CPR means cardiopulmonary resuscitation. The
procedure is intended to maintain and support circulation and to breathe for an individual with
cardiac arrest. The process aims to preserve and restore breathing, circulation and provide blood
flow and oxygen to the brain, heart and other crucial organs amongst patients under cardiac
arrest. Sudden death can occur if the organs do not receive enough oxygen or blood. There are
different techniques used in carrying out the CPR procedure. Some of the most common
techniques include the traditional chest compression CPR technique as well as the use of the
modern CPR devices, though the effectiveness of each method varies.
A2.The significance of the Problem
The significance of the problem is the need to analyse the survival rates for adult
patients under cardiac in hospitals. In-hospital cardiac arrests (IHCA) is one of the world’s
leading causes of death. According to Raffee et al. (2017, p.26), an estimated 200,000 IHCAs are
reported every year in the US alone, with less 20% of the patients surviving to discharge. Other
economies such as the UK have also recorded low survival rate for adult patients in hospitals
who suffer cardiac arrest. Christ et al. (2014, p.320) report that only 35.4% of the patients
admitted daily for cardiac arrest survive. Amongst developing countries, the mortality rate for
cardiac arrest patients is higher with the majority of the deaths been unwitnessed by the
caregivers. The mortality rates for cardiac arrest patients have been increasing globally despite
developments in the modern technology. There is a need for the development of stringent

EVIDENCE BASED RESEARCH 3
guidelines and practices regarding CPR on cardiac arrest patients to help reduce the mortality
rates to the in-hospital adult patients.
A3. The Current Practice
The current practice which relates to the healthcare problem relies on the use of the
modern resuscitation devices. Majority of the clinicians are adopting the use of the new electric
resuscitation devices which are said to attain better perfusion of the heart and brain within
laboratory settings. However, these devices have shown significant injuries to patients with no
substantial improvement in the survival rate compared to the traditional resuscitation methods
which include chest compressions using hands (Smekal, 2013). Some of the most common
devices currently used for resuscitation for patients facing cardiac arrests include the AutoPulse
devices and Lund University Cardiac Assist System (LUCAS) as described by Remino et al.
(2017, P.3).
The LUCAS device is one of the methods which have proved in useful during
percutaneous coronary interventions (PCI). The use of the invention is challenging since the
hands of the rescuer are within the field vision of the angiography. Also, the fluoroscopic x-ray
detectors within the device mandate the rescuers to conduct resuscitation manoeuvers in
nonefficient and uncomfortable positions. The modern device challenges the process of
resuscitation as the height of the cardiac catheterization table is high making the rescuers
position themselves in a way where it would be difficult to conduct an efficient CPR procedure.
These drawbacks relating to the use of the modern CPR procedures particularly the LUCAS
device do not show any substantial reduction in mortality rates for adults hospitalized with
cardiac arrests. The tools are expensive to purchase and maintain, notwithstanding the training

EVIDENCE BASED RESEARCH 4
cost as health practitioners need to be trained on how to use the devices (Giraud & Siegenthaler,
2014, p.2).
A4. Ethical Considerations
CPR shares common goals with other health interventions, which is to restore health,
preserve life and relief suffering as well as limiting disability. When initiating and ending
resuscitation, differences in cultural norms and ethical perspectives have to be considered. Some
of the ethical issues that might affect the healthcare organization or the caregiver include matters
pertaining futility, withdrawing or withholding interventions, practicing procedures on the newly
dead as well as communication and palliative care. During cardiac arrest, CPR attempts are
conducted. Rapid decisions have to be made based on the available information which can be
erroneous or incomplete. There is an increasing concern of the high budgets spent on CPR when
mainly the results are analysed based on the high percentage of the death of cardiac arrest
patients (Rubulotta & Rubulotta, 2013, p. 266).
B1. PICOT Table
P (patient/problem) Hospitalized adults
I (intervention/indicator) Modern CPR devices
C (comparison) Traditional chest compression CPR
O (outcome) Mortality