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Discuss about the National Safety and Quality Health Service Standards.

Standard eight of NSQHS

The EARLY SAVE program had been highly successful, as the initiatives taken during the program had helped in earlier recognition of the deteriorating conditions of the patients. The data, which had been put forward by nursing informatics team, can help in supporting the claim made:

  • Initially, before the introduction of the EARLY SAVE program, cases of acute respiratory distress were 25% that decreased to 10% after the introduction of the program. Similar had been the cases of suspected cardiac pain as well. Before the introduction of the program, cases of suspected cardiac pain and deterioration was 20%. This percentage reduced to 10%. This showed that the initiatives taken in the EARLY SAVE program had helped in developing the knowledge and skills of the healthcare professionals in ways by which they could easily identify the deteriorating cardiac condition of the patients and take necessary actions before the muscles of the heart were to a threatening limit (Mok et al. 2015, pp: 207-213).
  • The data also showed that the healthcare professionals had gained the skills of early recognition of the strenuous conditions in patients. Before the EARLY SAVE program, the MET team was called only for 20% of the cases for the worsening respiratory situations. However, after the EARLY SAVE program, the professionals could rightly identified more number of patients with such worsening situations accounting for about 30%. This showed that more lives of patients were able to be saved by the professionals as they had called the MET team at the right time after quick realizations of deteriorating situation of patients (Kollef et al. 2014, pp.424-429).
  • Moreover, the cases of patients being transferred to the ICU after the introduction of the program also showed that care had been taken by nurses in such a prominent ways and they were kept in such acute observation, that deterioration of the patient and consecutive transfer to ICU became lower and patients remaining on the ward became higher. Therefore, the health of the patients was maintained on the ward itself in a skilled manner and hence expenditure of the health resources was also controlled (Churpek et al. 2016, 368).

Standard eight, put forward by the National Safety and Quality Health Service Standards, advises the healthcare professionals as well as the organizations to take actions that are required to support and promote effective detection of the deteriorating conditions of the patient and take actions at the right time (NSQHS 2017). It also prevents expenditure of healthcare resources of the organizations and saves the economic outflow of the family members and emotional and mental turmoil faced by them (Jhonston et al. 2015, pp.752-763)..

The data that had been presented in the form of graph shows that there was indeed reduction in the number of patient transfers to ICU showing that rates of patients being admitted there had decreased. It is mainly because of effective and keen observation of the nurses and their skilled interventions that had helped the high-risk patients to overcome different risks. Patients staying in the ward were higher, showing deterioration rates had decreased as the general care given to patients was so expertise that patients did not undergo deterioration at all. The EARLY SAVE program had trained nurses so well that they could correctly summon the MET team at the right time immediately after sensing clinical deterioration of the patient.

The number of Code blue calls also reduced after the EARLY SAVE program showing that the healthcare professionals had become skilled the handle critical cases with expertise reducing their number 80 cases. Therefore, other healthcare organizations can follow such successful ventures and implement them in their organizational culture (Hayward, Vincent and Lasserson 2017, pp.e78-e85).


The presence of family members mainly during the times of resuscitation procedures has become one of the most important topics of debate not only among the different healthcare stalwarts and leaders but also among different nations of the world. The perspectives and attitudes of the nurses, physicians as well as family members towards family presence during resuscitation of patents are quite varied (Strassen et al. 2015, pp: 46-50). The different benefits as well as weakness of these procedures would be discussed in the assignment in order to reach to a particular conclusion. Three electronic databases will be searched like the “PUBMED”, “CINAHL”, “MEDLINE”. The search terms that would be fed into the system would be “family presence”, “resuscitation”, “benefits of family presence”, “perspectives in resuscitation rooms” and many others. Boolean operators like “AND”, “NOT” and “OR” would be selected. The essay will argue that presence of family members in resuscitation rooms are beneficial than their absence in the rooms with the patient.

EARLY SAVE Program

Very few articles have been found that had shown the negative aspects that remains associated when family members remain present in the resuscitation room. One of the qualitative studies, which had conducted broad ended questions to the healthcare professionals, had revealed interesting perspectives of the professionals. Some of them are seen to fear that they might be distracted from providing of care to the patients due to the distraught family members. Many other said that they go through emotional stress when family members of the patient are present in the room (Jenmark and Rosen 2017, pp: 7). An interesting article had also given a new perspective where they have found that family members might misunderstand any actions as errors. This aspect might create legal issues and obligations for the professionals if the patient dies as family members may complain about such errors. The family members might have emotional breakdown from seeing their dear ones fight for life and this might make them harm themselves (De Stefano et al. 2016, p.e0156100). When the family member faints in the situation, the resources might get diverted away from the resuscitating patients. Therefore, a specific cohort of professionals does not support presence of family members in the resuscitation duration (Porter et al. 2015, pp.98-105).

Other issues had been also put forward by other papers that also form a foundation of the argument of not allowing family members of patients in the resuscitation rooms. Often enough space might not be present for accommodation of the family members during resuscitation of the patient (Goldberger et al. 2015, pp.226-234). Often staff numbers might not be sufficient for handling and managing the family members of the patient, educating them before the entry and caring for them during their brief stay in the resuscitation rooms. Excessive interference of the family members during the entire procedure made the situations more strenuous for the professionals during the resuscitation activities (Tudor et al. 2014, pp.e88-e96) .


However, cost-benefit analysis had shown that the benefits associated with presence of family member overrides their absence in the resuscitation rooms. The family members can realize the seriousness of the condition of the patient. They can foster appreciation for the efforts of the CPR team ensuring everything possible was done for saving the patients. This removes the chances of legal obligations often filed by family members thinking that the professionals might not have provided the right care and interventions for saving their member. They can also provide important information to the CRP team (Porter et al. 2014, pp: 69-74).

Debate over family presence in resuscitation room

It can be helpful for the team to provide better care and they express the values of the patient to the team. They also support the needs of the patients by being physically present with them and calming them through prayer, touch, speaking and others. They provide emotional comfort to the patient making them feel that his or her family members are present as strength. This aspect mainly helps in reducing the guilt of the members in leaving the patient during the times of the crisis (Giles et al. 2016, pp.2706-2717).


The argument therefore found out that those people who remained in the resuscitation room with the patients were less anxious and not at all witnessed in comparisons to those family members who were not allowed to witness their family members (Hassankhani et al. 2017, pp.127-134). None of the family members who witnessed the resuscitation were reported to be frightened by the procedures and neither needed to leave the room. Most of them in fact stated that their grief was lessened by sharing the last moments with their loved ones. Even the scores of the psychological tests showed that they have lower levels of the intrusive imagery, lower grief scores and posttraumatic avoidance behavior (Powers and Candela 2017, pp.53-59).

From the above discussion, it can be concluded that there are different types of negative perspectives that had been put forward by healthcare professionals regarding family member’s stay in the resuscitation rooms. However, more high-level evidence papers had given information about the benefits. They have even showed that no additional stress occurs among family members when they are present n rooms. They neither disrupt the procedure nor lose their mental and emotional balance. Rather staying with patients in their end moments increases strength of patients and reduces the chances of repentance of the family members. So family members should be allowed to be present in resuscitation rooms.

References:

Churpek, M.M., Yuen, T.C., Winslow, C., Meltzer, D.O., Kattan, M.W. and Edelson, D.P., 2016. Multicenter comparison of machine learning methods and conventional regression for predicting clinical deterioration on the wards. Critical care medicine, 44(2), p.368.

De Stefano, C., Normand, D., Jabre, P., Azoulay, E., Kentish-Barnes, N., Lapostolle, F., Baubet, T., Reuter, P.G., Javaud, N., Borron, S.W. and Vicaut, E., 2016. Family presence during resuscitation: a qualitative analysis from a national multicenter randomized clinical trial. PloS one, 11(6), p.e0156100.

Giles, T., de Lacey, S. and Muir?Cochrane, E., 2016. Factors influencing decision?making around family presence during resuscitation: a grounded theory study. Journal of advanced nursing, 72(11), pp.2706-2717.

Goldberger, Z.D., Nallamothu, B.K., Nichol, G., Chan, P.S., Curtis, J.R. and Cooke, C.R., 2015. Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest. Circulation: Cardiovascular Quality and Outcomes, 8(3), pp.226-234.

Hassankhani, H., Zamanzadeh, V., Rahmani, A., Haririan, H. and Porter, J.E., 2017. Family Presence During Resuscitation: A Double?Edged Sword. Journal of Nursing Scholarship, 49(2), pp.127-134.

Hayward, G.N., Vincent, C. and Lasserson, D.S., 2017. Predicting clinical deterioration after initial assessment in out-of-hours primary care: a retrospective service evaluation. Br J Gen Pract, 67(654), pp.e78-e85.

Jermark, K. and Libby Rosen PhD, B.S.N., 2017. Family Presence During Resuscitation. Kansas Nurse, 92(1), p.7.

Johnston, M.J., Arora, S., King, D., Bouras, G., Almoudaris, A.M., Davis, R. and Darzi, A., 2015. A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery. Surgery, 157(4), pp.752-763.

Kollef, M.H., Chen, Y., Heard, K., LaRossa, G.N., Lu, C., Martin, N.R., Martin, N., Micek, S.T. and Bailey, T., 2014. A randomized trial of real?time automated clinical deterioration alerts sent to a rapid response team. Journal of hospital medicine, 9(7), pp.424-429.

Mok, W., Wang, W., Cooper, S., Ang, E.N.K. and Liaw, S.Y., 2015. Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. International Journal for Quality in Health Care, 27(3), pp.207-213.

Porter, J.E., Cooper, S.J. and Sellick, K., 2014. Family presence during resuscitation (FPDR): perceived benefits, barriers and enablers to implementation and practice. International emergency nursing, 22(2), pp.69-74.

Porter, J.E., Cooper, S.J. and Taylor, B., 2015. Family presence during resuscitation (FPDR): a survey of emergency personnel in Victoria, Australia. Australasian Emergency Nursing Journal, 18(2), pp.98-105.

Powers, K.A. and Candela, L., 2017. Nursing practices and policies related to family presence during resuscitation. Dimensions of Critical Care Nursing, 36(1), pp.53-59.

 safetyandquality.gov.au 2017, National Safety and Quality Health Service Standards Second edition, Australian Commission on Safety and Quality in Health Care [online] Retrieved from: https://www.safetyandquality.gov.au/wp-content/uploads/2017/12/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf [accessed on: 22nd October, 2018]

Strasen, J., Van Sell, S.L. and Sheriff, S., 2015. Family presence during resuscitation. Nursing management, 46(10), pp.46-50.

Tudor, K., Berger, J., Polivka, B.J., Chlebowy, R. and Thomas, B., 2014. Nurses’ perceptions of family presence during resuscitation. American Journal of Critical Care, 23(6), pp.e88-e96.

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