Inhospital Cardiac Arrest: Pre-Event Variables and Nursing Response

Abstract

This retrospective study examined the medical records of 100 patients who experienced an in-hospital cardiopulmonary arrest. The purposes of this study were to identify pre-arrest physiologic changes that may have occurred in the patient and to determine whether physician notification time, physiologic variables, patient location, and the presence of an electrocardiogram (ECG) monitor before the arrest affected the resuscitation outcome. The results showed that assessment variances were present in most patients before the arrest and also were recognized by the nursing staff. Implications for practice include formation of quality improvement screening tools to assess the patient's pre-arrest status, development of competency tests that include scenarios involving changes in a patient's physiologic parameters, staff education, and evaluation of current nursing policies for obtaining vital signs and assessments.

The effect of improving task representativeness on capturing nurses’ risk assessment judgements: a comparison of written case simulations and physical simulations

“…This is a judgement that health care professionals, including nurses, do not always perform optimally; physiological deterioration is often unrecognised, inadequately and/or inappropriately treated [22-24]. Early recognition of important changes in physiological parameters is critical if ‘failure to rescue’ and/or a critical event such as cardiac or respiratory arrest is to be avoided [25].…”

Prospective cohort study to test the predictability of the Cardiff and Vale paediatric early warning system

“…Studies in adults2 3 have shown that patients in hospital exhibit premonitory signs of cardiac arrest, which may be observed by nursing and medical staff but are frequently not acted upon. Similar findings have been observed in the condition of adult patients before admission to intensive care units (ICU) 4 5.…”

The Impact of an Admission Unit on Failure- and Late-to-Rescue Rates in the Emergency Department

“…Studies have shown that patients experience physiological changes up to 8 hr prior to cardiac or respiratory arrest (Considine & Botti, 2004;Franklin and Matthew, 1994;Goldhill, White, & Sumner, 1999;Rich, 1999). Healthcare providers realized that cardiopulmonary arrest could be prevented when early signs were noted and acted upon.…”

“…Those patients with a "do not resuscitate" order were also excluded from the study because their expiration would most likely not be the result of nursing care (Rich, 1999).…”