Essay: Evidence-Based Research For WHO And UN Supports Global Health.

Data analysis from the pre and post early save survey in the hospital

Discuss about the Evidence Based Research for World Health Organization and United Nations.

To demonstrate the effectiveness of the early save program, a pre and post survey was conducted in the hospital. From the results of the survey, it was realized that the program was indeed effective. This session will explain the reasons why the conclusion was made.

Data analysis from the pre and post early save survey in the hospital

Finegold, Aseria & Francis (2012) stated that the major cause of death for the emergency diseases is because of old age. This is as a result of the findings from their study which identified 82% of the victims to be above the age of sixty-five. With this knowledge, the early save team had to ensure this percentage is reduced. Resuscitation being the immediate response ensured the patients are kept stable and those who required further treatment were admitted for further investigation. This was found to be effective after the program was introduced as the percentage of lives lost was decreased. Instead of rushing patients to the Intensive Care Unit (ICU), the emergency response team was able to prevent this as the patients reached the facility in time for first aid.

In most cases, a seizure lasts for up to five minutes and may cause brain damage to the patient if no immediate reaction is taken (Trinka, Hofler & Zerbs, 2012). There is, therefore, the need for an immediate response from trained clinical teams.

From the research done, 20% of the callers reported seizure during the pre-early save survey which was the same percentage to the post early save which indicate that a number of people likely to be lost without a quick response. According to the GBD analysis by the Mortality and Causes of Death Collaborators (2013), the number of deaths resulting from seizure was presented to de 116,000 which was more than the 1990 survey by 4,000.  A change, therefore, had to be done and with the introduction of the early save the program, the death rate reduced by 15% which is evidence of its effectiveness.

Rubenfeld et.al (2005) noted that acute respiratory distress has led to high mortality rate ranging from 20 to 50% and is associated mostly with old people. The symptoms which include fast breathing, low level of oxygen in the blood and shortened breath begin within two to three hours of the actual incident and can sometimes occur only after one to three days (Bakowitz, 2012). This gives ample time to report to the nearby health facility in time for supposed treatment.

Patients Suffering from Seizure

Since the introduction of the early save the program, the percentage of patients who get a response and only remain in the ward for observation rose from 20% to 50%. This is an indication that the program is capable of saving lives and cuts the cost of having to be transferred to the intensive care unit (ICU) which is beneficial to the families of the patients as well as the medical practitioners.

Woo & Schneider (2009) identified heart attack and esophagus rapture to be among the causes of cardiac pains. A thorough medical examination of the patient is, therefore, important to determine the real cause of the suspected pains.

In the survey, the percentage of callers with suspected cardiac pains dropped from 20 % to 10%. The reduction could be attributed to prior treatment that the patients had been subjected to. Patients were admitted to the hospital early enough; the causes reduced or eliminated which explains the reduced percentage.

According to the Rabe, Hurd & Anzueto (2007) research, respiratory functions can be worsened due to inhalation of pollutants. The symptoms include shortened breath and difference in the number and color of the respiratory track phlegm. These symptoms may last for a number of days and may end up not being detected in the body.

The percentage of Medical Emergency Team (MET) callers rose from 20 % to 30% during the post early save survey. Walters (2014) suggested that the best approach to the treatment of this particular problem is by therapy. Due to the many numbers of days of the preliminary symptoms of the worsened respiratory functions, most patients were not able to detect them in time to report which could explain the increased percentage. The early save team are however on the lookout which is demonstrated by the reduced percentage of those transferred to the ICU and HDU. Most of the patients are given immediate treatment and end up in the ward just for observations.

From the above illustrations, the program has been proved to be effective and has a potential of helping the hospital save even more lives.

As a way of reducing the death cases in the hospital, an ‘early save’ program has been implemented to help in early recognition and response to clinical deterioration. It is supposed to work with the existing code blue response process to attend to severe threatening medical emergencies like a cardiac attack. The program involves education of the clinical staff, a more formalized Medical Emergency Team (MET) process, and the introduction of an Observation and Escalation Chart. A pre and post survey investigation had been done which proved that the program is beneficial to the patients as well as to the medical practitioners. The report will be based on journals and databases in the field of medical practice. From the preliminary research done, I think family members presence is not a hindrance to the resuscitation process due to the reasons below.

Patients with Acute Respiratory Distress

In relation to the quality of the resuscitation, it was proved that the quality of the process is similar in the presence or absence of family members. There is, however, a slight difference in connection to the time for the resuscitation process (Goldberger et.al, 2015). In the presence of the family members, the patients regained consciousness faster than when they are alone with the doctors. This proves improved quality of resuscitation meaning a good process to be carried out.

The resuscitation process showed a big difference in the aggressiveness with the presence of the family members (Goldberger et.al, 2015). Most patients who undergo the process in the presence of their loved ones end up having more aggressive process and as discharged quickly or transferred to other units for further treatment.

Oczkowiski et.al (2015) review concerning the effects of the presence or absence family during resuscitation is based on the chances of loss of life during or after the process. In their study, there is no evidence of suicide trend for the family members who witness the resuscitation of their loved ones within 28 days after the process. This is an indication that even if they are present or not, they are not likely to attempt suicide considering the experience they get or what they witness as a result of depression. This lack of negative effect makes resuscitation to be considered good for the patients.

In addition, the Oczkowiski et.al (2015) report revealed that the number of patients who die during the resuscitation process was not affected by the presence of the family members. Those who die in the absence of their family members were the same percentage as the ones who succumbed in their presence. The effect was 95% positive which indicates that the cause of death is not as a result of their presence but due to other reasons altogether making resuscitation a good process to patients.

The amount of time required to complete the resuscitation process according to Oczkowiski et.al (2015) is also not affected by the presence of the family members. According to them, it took about twenty-six minutes to complete resuscitation for each patient in the presence of their loved ones which was about five minutes less than in usual cases. This is an indication that their presence is more advantageous to the process than when they are absent and therefore a recommended move.

Flanders & Strasen (2014) in their research also indicated that the presence of the family in the room during resuscitation is of benefit. This was also proved that the patients are more motivated to continue fighting for their lives when close to their family members. There is, however, no data to prove this concept and it, therefore, remain as a claim. The quality of the process is also high and can be conducted within the shortest time possible.

In conclusion, it is evident that the presence of family members has positive effects on the process of resuscitation. Resuscitation is therefore proved to be a good process to be performed to anyone with cardiac disease. The family members should also be allowed to be present during the process as a way of motivation to the patients. From this report, the early save program is also a good project that the hospital should continue working with in collaboration with the available cold blue practices.

References

Bakowitz M. (2012). Acute lung injury and the acute lung respitratory distress syndrome in the injured syndrome in the injured patient. Scandinavian Journal of Trauma, Resusciatation and Emergency Medicine.

Finegold J., Aseria P. and Francis D (2012). Mortality from ischaemic heart disease by country, region and age: Statistics from World Health Organization and United Nations. International Journal of Cardiology

Flanders S. and Strasen  J. (2014). Review of evidence about family presence during resuscitation. Critical care nursing clinics of North America

GBD. Mortality and Causes of Death Collaborators (2013). Global, regional and national age-sex specific all-cause and cause-specific mortality for 240 causes of death , 1990-2013: A systematic analysis for the global burden of disease study. Lancet

Goldberger Z., Nallamothu B., Nichol G., Chan P., Curtis R., Cooke C. and American Health Association (2015). Family presence during resuscitation and patterns of care during in-hospital cardiac arrest: Circ Cardiovasc Qual Outcomes

Oczkowiski S., Mazzetti I., Cupido C. and Robichaud A. (2015). The offering of family presence during resuscitation: A systematic review and meta-analysis. Journal of intensive care.

Rabe K., Hurd S., and Anzueto A. (2007). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: GOLD Executive Summary.

Rubenfeld D., Caldwell E., Peabody E., Weaver J., Martin D., Neff M., Stern J. and Hudson L. (2005). Incidence and Outcomes of Acute Lung Injury. New England journal of medicine.

Trinka E., Hofler J. and Zerbs A (2012). Causes of status epilepticus. Epilepsia

Walters J., Tan D., White C. and Wood R. (2014). Different durations of corticosteroid therapy for exacerbations of chronic obstructive pulmonary disease. The Cochrane database of systematic reviews.

Woo K., and Schneider J. (2009). High risk chief complaints: chest pains-the big three. Emergency medical clinic. North America