Nurses' Views on CPR for End of Life Patients

Title
Nurses views on delivering cardiopulmonary resuscitation on end of life patients.
Introduction
As to have the discussion of the cardiopulmonary resuscitation (CPR) at the end of life can be
extremely difficult as per the view of the nurses. The nurse has the need to make the proper level
of attention and change in the way of different perceptions in make the patient have the recovery
in swift manner. The health assistants have the helping to the patient to make the assessing the
cardiopulmonary resuscitation should be attempted in the event of cardiorespiratory arrest. The
chosen topic for the literature review is cardiopulmonary resuscitation (CPR) on end of life
patients. This was the chosen topic as evidence-based analysis shows that nurses are faced with
an ethical predicament regarding CPR interventions. The purpose of the literature review is to
look into nurses perceptions surrounding performing CPR for terminally ill patients such as end
of life patients. As expectations and presumption that all patients suffering cardiac arrest should
be offered CPR, Sehatzadeh (2014) suggests for terminally ill patients CPR is not appropriate or
a beneficial intervention which leaves an ethical dilemma as to carrying out CPR or face possible
litigation when a patient dies, if CPR is not carried out. The staff have the need to make the
proper involvement of the patient along with failing in amusing process in order o have the
reduction f the risk in way of administration the unwanted level of treatments in significant
manner.
Hansen , Lauridsen , Schmidt and Løfgren (2019)
In the term of physicians, almost one third don’t have the feeling of being competent in order to
take the decision for terminating CPR. Most of the nurses and physicians have their knowledge
in term of weaken and poor termination guidelines. The both of the professions are reported to be

the invalidates along with being controversial factors by turning to be single reason for
termination CPR.
In the recent term, nurse and doctors have been reported in term of lacking he CPR knowledge
and skills along with no debriefing the services to be provided after their encounter of CPR.
There is the need for participating hospitals for addressing the different level of challenges and
obligations that’s can have the negative level of impacts on the CPR outcomes. There challenges
rea such as the staff shortages, the initial of the hospitals and overpopularized, there have been
identification of the emergency trolleys along with CPR requirements , absence of CPR policies
and guidelines, absence of CPR teams along with the limited level of CPR competencies in the
term of doctor and nurse who are lacking the debriefing sessions after being in the several
attempt of CPR.
As per the view of Pyl and Menard (2012), Hence the goal of this projects in to have the proper
level of identifications of the different barriers and faciliatory in to be used for there CPR
decision makings aid along with properly evaluating there different nursing perceptions. This
will be providing the patient, the effective decision support systems by proving their positive
level of attituded toward patient decision support and decision aids. On the other hand , the nurse
have identified as in the specific barriers along being facilitates in their commentaries by
clinically supporting the relevant data in support of patient idea by integrating into the daily
level of nursing practices.
The aim of the respective study is in order to have the describing the relative level of experiences
and different thoughts of the all the member of an integrated heart failure and palliative care
team concerning talking about CPR with end-stage heart failure patient. In addition to that’s,
there result professionals caregivers have the integrated heart failure and palliative homecare by
struggling the issue of the CPT at their end stages heart failure patients. On the other hand, they
are also feeling the level of challenges over the actual conversations about the CPR in term of
patients and relatives Brannstrom and Jaarsma (2015) . Despite talking them about CPR with
patients and relatives is difficult, the study participants described that doing so is important, as it
could be the start of a broader end-of-life conversation

Sehatzadeh (2014) articulates patients with advanced chronic health conditions, the survival rate
after a CPR episode is shown to be very low, with 1 in 10 who survive being discharged from
hospital.
Anticipatory decisions arise for nurses regarding CPR such as considering to perform CPR and if
intervention is appropriate and in the best interest of the patient. Healthcare settings generally
have policies in place for staff members as a measure in such circumstances. Resuscitation
Council guidelines (2015) recommend for healthcare professionals such as the nurse to avoid
inappropriate intervention of CPR and decisions should be made lawfully by complying with the
law and relevant legislations such as Mental Capacity Act (2005) and Human Rights Act (1998).
Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) document was formulated for the
purpose that patients do not get inappropriately resuscitated(resuscitation council, 2015).
Contradicting factors regarding DNACPR have highlighted little information and involvement is
given to patients and family members(Perkins et al ,2016). Professional bodies have released
published guidance on decisions relating to cardiopulmonary resuscitation stating the law points
out, there should be decisions in favour of patients involvement and needs to be justifiable
reasons for the patient not to be involved (Resuscitation Council, 2015). In any circumstance
where patients are not involved or informed regarding DNACPR this decision should be based
on patients harm or benefit which should be clearly documented stating reasons for the decision
of not informing patients(British Medical Association, 2020).
The GMC (2020) guidance states end of life patients receiving care and treatment and sensitive
decisions regarding CPR must be tailored to the patient's individual desire and current health
condition. BMA (2020) guidance states healthcare professionals must respect patients' decisions
if they insist on going ahead with CPR, even if a healthcare professional deems it to be futile
which could cause a dilemma as they also state the situation should be reviewed at the event of
CPR. NMC (2018) states healthcare professionals may encounter situations where patients
feature irreversible death such as rigor mortis, if this is the case healthcare professionals should
be fully supported not to initiate CPR.
Aims and Objective

The aims of the literature review is to determine the barriers that a nurse faces surrounding CPR
with end of life patients . The objective is to get an understanding of modern day challenges
surrounding CPR with end of life patients in practices ranging from legal, ethical and
professional choices and decision making.The methodology will be achieved by selecting and
searching through relevant literature Webster et al. (2010). There is need to have the formation
of the different clinical questions in order to be best answers by using the different research
designed in perfect manner. There is the need to have the formation of the structures of the
different effective questions in the term of answerable formats with the use of different
populations, intervention, comparator, outcome (PICO) framework. After having the
establishments of there different type of question which is being required in order to have the
answering the question in effective manners
Methodology
Search Strategy
To find the relevant research literature the researcher used online sources via the web to scan
through databases mainly using the University of Wolverhampton and science direct database.
The purpose of using the sources mentioned above are widely accepted reputable sources to
search literature. Having the ability to explore through databases and pick out literature is vitally
important for the purpose of the research design and gathering evidence based practices (Ellis,
2016). To acquire literature that addressed the research, question the researcher typed the search
term health care professionals views on cpr for end of life patients, this same search term was
deployed in to both databases, no keywords or Boolean operators were implemented in the
search term.
The Wolverhampton database produced 695 topics and science directed 685 topics relating to the
subject; this is evident in the data extraction table (see appendix 1). filters were used to narrow
down the results in both databases the criteria’s included resource type to journal articles, dates
from 2010-2020, peer reviewed and search subject of cardiopulmonary resuscitation in
Reference to support why you choose these limits