Effectiveness Of Early Save Program In Improving Clinical Deterioration Response In Hospital

There were 140 Code Blue calls pre EARLY SAVE and 60 post, mainly for cardiac or respiratory arrest.

1.Based on the data presented, do you think the EARLY SAVE program has been effective in improving early recognition and response to clinical deterioration in your hospital? Why/ why not?

2. How might the data obtained pre and post the EARLY SAVE program be used by the hospital when reporting against National Safety and Quality Health Service (NSQHS) Standard 9: Recognising and responding to clinical deterioration in acute health care?

Analysis of the Data Presented

Ideally, the early save program has been effective in improving the resuscitation and health care system of the patients in the hospital. Based on the graph before the program was introduced that is (pre), there was a large number of deaths of the patient who could not make it after being resuscitated that is around 25% has been interpreted from the graph (Hockenberry, Wilson and Rodgers, 2016, p.20). This shows that the medical emergency team (MET) could not act or read the signs earlier (Hockenberry, Wilson and Rodgers, 2016, p.20). After the program was introduced, the number of death has represented from the graph resulting from those who could not make it in resuscitation decreases. It dropped to about below 10% this is due to early medical attention by the medical emergency team. This is also to the fact that after the introduction of early save programs the number of medical team increases from 160 to 360.

Furthermore, after the introduction of the early save program the code blue patient decrease from 140 to only 60 in post early save (Hockenberry, Wilson and Rodgers, 2016, p.20). This is due to the fact before the opening of the problem there was about 20% patient with cardiac pain this in pre-early before the program was introduced and 10% after the program was introduced (Hockenberry, Wilson and Rodgers, 2016, p.20).

From the graph, it can be seen that patients who were  transferred to the intensive care unit (ICU) was high in pre-early save program about 35% from the graph and about 20% after the introduction of the post early save the program (Vincent and Lederman, 2017, p. 676). Notably, this is as a result of early recognition of patient’s signs by the medical emergency team. Moreover, by an increase of the medical team, the patient concerns were able to be detected early, and they were early medicated before the signs could worsen.

 It can also be seen from the graph represented that before the program was initiated, there was a low number of patients who were admitted in the ward as compared to post early save programs. From the understanding, we that probably most of the patient signs could have been indicated later and most of them were taken to an intensive care unit and high dependency unit because their condition had worsened. After the post early save programs most of the patient were indicate earlier, and the medical emergency team was alert, and most of the patient was admitted in word reducing the number of patients who were taken in intensive care unit.

Effectiveness of the Early Save Program

The national safety and quality health services(NSQHS)  was initiated by our government commission on safety and quality care with the help of jurisdictions and wide a range of other organizations and individuals including health professional and patients (Hockenberry, Wilson and Rodgers, 2016, p.20). Standard 9 states that appropriate and timely care to a patient whose condition is deteriorating.

The main objective is to ensure that patient deterioration is early recognized and the correct measure is taken this standard is applied for both major and minor patient in acute healthcare. From the graph the standard 9 (NSQHS) has been observed after the early save program was established in this hospital (Vincent and Lederman, 2017, p. 676). For instance, we can see the number of medical emergency team (MET) was increased from 160 to 360 which are good forward.

This ensures that patient with deteriorating health are early discovered and with a large number of the medical team their requirements are handled as soon as it is required. Moreover, the patient with code blue was reduced from 140 in pre-early to 60 in a post early save a program (Vincent and Lederman, 2017, p. 676). The graph also shows that there was a reduction of death resulted from resuscitation in a post early program compare to before the program was established because most of the patient critical condition was discovered earlier and the medical team acted quickly.

Resuscitation is the procedure in which it involves helping physiological disorder working correctly such as lack of breathing and heartbeat(Wachterman, Pilver,Smith,  Ersek, Lipsitz, and Keating, 2016, p.1095) Resuscitation in the presence of relatives has always been controversial  most of the hospitals since past have always not try to involve the relatives in this process especially when they involve adult resuscitation but due to emergence trends and increasing pressure from relatives and patient some  of the hospitals have come to terms in involving family member during the procedure.

 I think it will be of good certification for relative involvement to their patient resuscitation so that they come to terms with maybe the last moments with the relative in case he or she passes on (Cooper et al., 2016). Intense research being carried on this debate will adversely help in taking patient and relative’s involvement being taken to consideration by professional on making steps towards making an ethic on more medicine practice. Involvement of patient’s relatives usually assists them to come into terms with the reality in case the patient dies and prevent long denial and brings stability during bereavement.

Benefits of Involving Family Members in Resuscitation Process

Moreover, most of the relatives would prefer spending the last moments with their patients and during this process ‘a list if he or she dies they would say that they had last moment with the patient also it will be comfortable to understand the cause of the death and creating a good and healthier for the departed family members (Olding et al., 2016, p.1183).

Some television coverage such “Casualty” and “ER” usually shows images and process resuscitation during late night viewing (Vincent and Lederman, 2017, p. 676). Taking to considering that it is just fantasy, but it can help in reality. The price, option for this programs shows that the intubation and defibrillation are not something unrealistic as the healthcare professionals make the relatives see (Hockenberry, Wilson and Rodgers, 2016, p.20). Most of this television programs are realistic and always help to prepare the relatives both emotionally and psychologically.

The patient who is to undergo the resuscitation usually when the family members are present, they will feel attached with them and feels that they offer comfort and sharing a strong emotionally experience as in the case of Meyers et al. (2000) where the resuscitation was successful. In additionally in a circumstance where the process of resuscitation fails, and the patient dies the relatives will believe that by their presence (Hockenberry and Wilson, 2018, p.23), their worries have been reduced and experiences during that time. This experience will help them during a hard time of grieving in the later days.       

Most family members are not usually focused on the technical process going around their loved one as in the case of Barret and Wallis (Kisorio, &Langley, 2016 p. 35). The family member assumes that too much emphasis is usually placed on such procedure and finding out from family member some few months after the process of resuscitation majority of them could not remember what procedure they had seen taking place.

Involving family member during the process of resuscitation will family member to come into terms that everything possible was done to bring the patient back to life (Giles de Lacey and Muir?Cochrane, 2016, p. 2706). Besides, it helps the family member reduce the suspicion of what happened behind the closed door and unrealistic effort that was tried. It will also help the family member to have the last goodbye with their loved one and helps the patient to come to the reality of death.

Conclusion

A family member should be given a chance to attend resuscitation in case the patient wishes them to be around. Consequently, this will give patient courage to deal with their current situation (Chapple, 2016). Additionally, it should also be understood that it is not just any person who is allowed there some of the family members may become too emotional and adversely affect the procedure. Such a family member should be restricted from accessing the area so that the process of resuscitation can be undertaken.

In the case of a minor patient, studies indicate that most of the children who are to undergo resuscitation would love the presence of their parents because they are usually comforted and shown love and support (Cooper, Koritsanszky, Cauley, Frydman, Bernacki, Mosenthal, Gawande, and Block, 2016, p. 1). Mostly for many relatives they usually see it is advisable to be present when the process of resuscitation is taking place. They will always believe that it’s their obligation and right to be there. Essentially their presence beside them will make them understand the perseverance of their loved ones. Additionally, it helps the family member to remove the doubt about the patient condition and that everything possible is being done.

Relatives being present in resuscitation room help in reducing anxiety and having negative feelings about what is happening to their patient. Additionally, the presence of relatives makes it possible for the passing of information regarding patient’s situation (Bertman, 2016). It also provides a chance for the family members to come together to cheer up, comfort, and support their loved one.  

Member of the relatives presents helps to improve the medical decisions making, patients care, and communication with the member of the relatives(Kon, Davidson, Morrison, Danis, &White, 2016, pp.188) Research also shows that due to the presence of the members of the family there is always no or minimal patient care disruptions. Also, the due presence of family member sign and symptoms of stress syndromes, depression, and traumatic grief are less or minimal when the family members are presents during the process of resuscitation than when they are not (Hockenberry, Wilson and Rodgers, 2016, p.20). There are common no wide psychological effects reported among the family members at the bedside and compared to other families who did not attend.

References List  

Bertman, S.L., (2016). Facing death: images, insights, and interventions: a handbook for educators, healthcare professionals, and counselors. Taylor & Francis. file:///C:/Users/hp/Downloads/9781135059187_googlepreview.pdf

Chapple, H.S., (2016). No place for dying: Hospitals and the ideology of rescue. Routledge. https://www.taylorfrancis.com/books/9781315423449

Connor, S.R., (2017). Hospice and palliative care: The essential guide. Routledge. https://www.taylorfrancis.com/books/9781317221173

Cooper, Z., Koritsanszky, L.A., Cauley, C.E., Frydman, J.L., Bernacki, R.E., Mosenthal, A.C., Gawande, A.A. and Block, S.D., (2016). Recommendations for best communication practices to facilitate goal-concordant care for seriously ill older patients with emergency surgical conditions. Annals of surgery, 263(1), pp.1-6. https://www.ingentaconnect.com/content/wk/sla/2016/00000263/00000001/art00002

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. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13046

Hockenberry, M.J. and Wilson, D., (2018). Wong's nursing care of infants and children-E-book. Elsevier Health Sciences. https://books.google.co.ke/books?hl=en&lr=&id=w7RqDwAAQBAJ&oi=fnd&pg=PP1&dq=Hockenberry,+M.J.+and+Wilson,+D.,+2018.+Wong%27s+nursing+care+of+infants+and+children-E-book.+Elsevier+Health+Sciences.&ots=uIbH8uqJL0&sig=rb4UHqkd-Wc88_9vm_3CBImUnMU&redir_esc=y#v=onepage&q=Hockenberry%2C%20M.J.%20and%20Wilson%2C%20D.%2C%202018.%20Wong's%20nursing%20care%20of%20infants%20and%20children-E-book.%20Elsevier%20Health%20Sciences.&f=false

Hockenberry, M.J., Wilson, D. and Rodgers, C.C., (2016). Wong's Essentials of Pediatric Nursing-E-Book. Elsevier Health Sciences. https://www.repository.embuni.ac.ke/bitstream/handle/123456789/1176/Study%20Guide%20for%20Wong's%20Essentials%20of%20Pediatric%20Nursing-%20Marilyn%20Hockenberry.pdf?sequence=1&isAllowed=y

Kisorio, L.C. and Langley, G.C., (2016). End-of-life care in intensive care unit: Family experiences. Intensive and Critical Care Nursing, 35, pp.57-65. https://www.sciencedirect.com/science/article/pii/S0964339716000239

Kon, A.A., Davidson, J.E., Morrison, W., Danis, M. and White, D.B., (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical care medicine, 44(1), p.188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4788386/

Olding, M., McMillan, S.E., Reeves, S., Schmitt, M.H., Puntillo, K. and Kitto, S., (2016). Patient and family involvement in adult critical and intensive care settings: a scoping review. Health expectations, 19(6), pp.1183-1202. https://onlinelibrary.wiley.com/doi/full/10.1111/hex.12402

Vincent, C. and Lederman, Z., (2017). Family presence during resuscitation: extending ethical norms from paediatrics to adults. Journal of medical ethics, 43(10), pp.676-678. https://jme.bmj.com/content/43/10/676

Wachterman, M.W., Pilver, C., Smith, D., Ersek, M., Lipsitz, S.R. and Keating, N.L., (2016). Quality of end-of-life care provided to patients with different serious illnesses. JAMA internal medicine, 176(8), pp.1095-1102. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2529496