Posted: March 24th, 2023
Organizational changes are necessary and critical to improving the quality of care in healthcare facilities. Many organizations use effective clinical practice guidelines that define success, especially when making decisions about care delivery. The procedures are systematic statements that direct health care professionals on the way to decide about the most appropriate care for a particular patient situation (Murad, 2017). Such experts support nurses and other care providers to adopt interventions that are suitable for patients, such as those suffering from cardiac arrest. They help them to identify the practice procedures that can help patients suffering from chronic and other conditions and seeking care at the hospital. Clinical guidelines create uniformity in the organization and address the disparity in the provision of services to patients. They support the identification of the relevant patient populations to treat using the implemented intervention. These guiding principles also allow providers to engage patients in the management of their conditions using the self-care model. Hence, patients are encouraged to make informed decisions regarding their health. Over the last few decades, many hospitals have designed clinical guidelines to improve performance and patient outcomes. My healthcare organization has been using the post-cardiac arrest hypothermia as a clinical guideline.
Introduction to the Healthcare System Practice Guideline
The evaluation is about the proper use of post-cardiac arrest hypothermia in the healthcare organization. The guideline was introduced due to the poor neurological outcomes, which were recorded after a cardiac arrest. The factors behind the use of the guideline are as a result of negative experiences individuals undergo after a cardiac arrest. Such experiences lead to increased use of resources to treat the complications that might occur after the cardiac arrest. Research evidence indicated the potential for positive results from using therapeutic hypothermia, which inhibits the detrimental chemical reactions that accompany cerebral anoxia. Improved neurological outcomes have been revealed in human and animal studies after the utilization of induced, mild hypothermia for cardiac arrest patients. Although the procedure is proven effective for use among the out-of-hospital cardiac arrest patients from ventricular fibrillation, the process could also be useful in the treatment of cardiac arrest patients, such as in-hospital asystolic or PEA arrests. Hence, to achieve the required benefits of the procedure, nurses and other healthcare providers should understand the proper use of the intervention (Nolan et al., 2003). The guideline provides a detailed analysis of indication for post-cardiac arrest hypothermia.
A guideline is a decision-making tool that supports collaboration between health care providers and the patient to improve outcomes. It involves the inclusion of a patient in the decision-making process in the use of post-cardiac arrest hypothermia as a management tool. It includes a critical analysis and logistical guidance to help users of the intervention to apply it in practice appropriately to achieve positive results. It was developed after a careful inquiry of evidence to reveal what worked and the limitations of the post-cardiac arrest management procedure (Cheung et al., 2006). It was also necessary to ensure that it was used appropriately to achieve the benefits. The development was a rigorous process to find and use the best evidence for the application in practice depending on the current need, such as the number of individuals who could benefit from the procedure and the complexity of their health problem. For instance, the guideline includes how to implement the intervention depending on the nature of the cardiac arrest and the extent of the presented complications (Bernard et al., 2002). The information is critical to decide on the approaches, which would be used to implement the procedure for post-cardiac arrest management.
Implications of the Guideline to Different Professionals in the Healthcare System
The clinical practice guideline affects the work of different healthcare professionals in the organization. The affected professionals include nurses, practitioners, pharmacists, technicians, health researchers, nurse educators, and policy analysts. These individuals in the healthcare facility are affected because of their role in the provision of quality care to patients. The clinical guidelines include the best practice for health care providers, including a proper assessment to determine the relevance of the procedure in a medical condition. Nurses are one of the most affected groups because of their role in the continuum of care. They should create and use the information to recommend the kind of care and support needed by cardiac arrest patients. They also share the data with other professionals in the organization to facilitate care. The professionals should work closely with patients to support quality care outcomes. Nurse researchers and educators develop the necessary knowledge and skills to use the guidelines effectively. They engage in the continued collection and analysis of data to support the use of the intervention (Engelke & Marshburn, 2006). They apply the knowledge to train others about the effective use of the clinical practice guideline.
Nurse practitioners are affected by the use of clinical practice guidelines in the health care organization. They are the providers of primary care to patients, such as those suffering from cardiac arrest. Their work includes successful assessment, diagnosis, and treatment. Thus, they treat individuals who require post-cardiac arrest hypothermia. Given their role in the diagnosis and treatment (working closely with nurses, technicians, and pharmacists), they need to comprehend the extent clinical practice guidelines influence their work in the hospital. For example, they should understand the nature of the cardiac arrest necessary to recommend the post-cardiac arrest hypothermia (Nolan et al., 2003). The guidelines affect technicians because of their role in the diagnostic process for cardiac arrest. Their work informs the services provided by other medical providers. They need to understand and recommend the resources necessary for the effective use of post-cardiac arrest hypothermia. Pharmacists are also affected by the implementation of the clinical guideline at the healthcare organization. They provide the required resources for any intervention. Therefore, they play a significant role in advising patients on the resources necessary to use post-cardiac arrest hypothermia in the management of their medical conditions. The health care providers should work together to implement the intervention successfully and support post-cardiac arrest care.
Evidence Used to Define the Clinical Practice Guideline
The healthcare organization applied evidence from research to design a clinical practice guideline for the use of post-cardiac arrest hypothermia. The increase in the rate of detrimental outcomes for patients suffering from cardiac arrest informed the need for such clinical guidelines. Organizational evidence supported the application of the clinical standards at the hospital (American Heart Association Guidelines for CPR and Emergency Cardiovascular Care, 2005). The healthcare organization revealed the need for the guideline to improve patient care and outcomes following a cardiac arrest episode. The guideline includes the circumstances that require the procedure and those conditions that the providers should avoid its use, such as in case the approach places the life of the person in danger. Consequently, its use requires a detailed assessment of the condition of the cardiac arrest patient before using the procedure. Clinical trials are some of the common sources of evidence for the efficacy of post-cardiac arrest hypothermia (The Hypothermia After Cardiac Arrest Study Group, 2002; Polderman, 2004). The hospital management used various sources of support for the implementation of the procedure in the organization to avoid potential adverse effects of cardiac arrest patients.
Panels of experts also provide reliable evidence to support the use of a clinical practice guideline in a hospital. Medical professionals converge to deliver specific information regarding the need for the guideline and inform health care professionals about the use. They play this role after clear evidence of efficacy and appropriateness of the procedure for the medical condition. They use technical and analytical tools to generate evidence. Their input provides critical support for the use of the guideline and related method for the treatment of cardiac arrest and post-treatment management (Polderman, 2004). They also help in determining whether the healthcare facility has the required resources to implement and use the intervention. For instance, the hospital developed and utilized the guideline due to the availability of qualified nurses and other providers to use post-cardiac arrest hypothermia (The Hypothermia After Cardiac Arrest Study Group, 2002). A panel of medical experts has proven that the intervention is suitable and applicable to the hospital.
Studies have confirmed the efficacy of the clinical guideline with a recommendation for the best practice and use. Polderman (2004) conducted a study in the ICU that provided support for the use of the intervention in cardiac arrest management. The study established the efficacy of the procedure when performed on the right patient and under the right circumstances. Nonetheless, researchers have indicated the importance of careful assessment of an individual before implementing the process. Nielsen et al. (2013) stated the need for proper evaluation of the circumstances under which the intervention is applicable. The study also included the actual implementation procedure, targeted temperature management at 33°C versus 36°C after a cardiac arrest. The amount of temperature used during therapy plays a vital role in the success of the intervention.
Findings from the research reveal the need to match the procedure to the patient because if used on the wrong population, it might affect the outcome and effectiveness. The clinical practice guideline was implemented as the guidance to prove the need and efficacy of the intervention as part of the long-term care of cardiac arrest patients. Furthermore, the process includes the need for ongoing interaction and communication with the patient throughout the process of treatment to allow them to make informed decisions. Collaborative efforts in healthcare processes have proven necessary in the achievement of positive practice and patient outcomes (Engelke & Marshburn, 2006). The medical care providers should avoid performing any procedure devoid of the consent of the individual. The patient should understand all information given by the nurses and other practitioners to approve the process, which is part of the use of evidence-based patient-focused care (Melnyk & Fineout-Overhold, 2019). Patient-centered care should be at the core of the application of the clinical guideline and the intervention.
The Level of Evidence Used in the EBP
The evidence used in the development of the clinical guidelines involves proof of proper selection of patients for mild therapeutic hypothermia as well as the procedure for induction of the same in the hospital. For a positive outcome, it is necessary to ensure that the process is confirmed effective in similar circumstances. It is also imperative to understand the level of evidence used to support the efficacy of the intervention. The level of evidence is utilized in nursing and clinical research to show the quality of the research available for the therapeutic intervention. The level is usually assigned to a study based on the method utilized in collecting the data. Besides, the professional using the guideline should consider the validity and applicability of findings in practice (Young, Rohwer, Volmink, & Clarke, 2014). The type of evidence used in supporting the efficacy of the clinical guideline is a systematic review of evidence. The analysis of randomized controlled trials provides the level I evidence because they are high-quality sources of support for interventions. They can be useful to support clinical decision-making among health care providers in the hospital.
The studies reviewed to support the effectiveness of the organizational change provided information about the proper use of mild therapeutic hypothermia among patients with cardiac arrest. Care providers use the evidence to support the application in practice. For the first level of evidence, researchers reviewed several findings to recommend clinical action. For instance, a systematic analysis of two to five CRTs could generate the evidence required to support the adoption of recommendations in the organization. Polderman (2004) conducted such a review to establish the effectiveness of the therapy. The author endorsed the available findings of the efficacy of mild therapeutic hypothermia in persons with cardiac arrest episodes. Many of the reviewed studies indicated the suitability of the therapeutic process among the patients. Besides, they focused on the downside of the use of the procedure, such as the use of extreme temperatures, which might end up harming the person. Therefore, evidence recommends proper and supervised use of the treatment to benefit cardiac arrest patients.
Personal Opinion Regarding the Use of the Guideline
The hospital has a practical clinical guideline to inform the use of mild therapeutic hypothermia in individuals with cardiac arrest. It helps health care providers to determine the appropriate use, such as which patients to include in the treatment and the level of the cardiac arrest to focus on. Besides, providers understand the existence of the guideline that directs their decision-making when working with patients. The hospital uses the guideline as part of the training process for the hospital staff on the available medical interventions for cardiac arrest cases. It is also the basis for medical practitioners to avoid detrimental outcomes among the target patient population. While working at the hospital, I have seen the guideline in use when interacting with cardiac arrest patients. For instance, nurses conduct a comprehensive evaluation of the medical condition before implementing the procedure. Since not all cases of the condition may require treatment, it is important to determine when and how to apply it in practice.
I have also observed the importance and effectiveness of collaborating with the patient in the care plan. Evidence-based practice suggests the importance of putting the patient at the core of the clinical process as well as giving them the necessary information and allowing them to participate in their treatment process (Young, Rohwer, Volmink, & Clarke, 2014). The guideline informs care providers about the need to consult with competent patients or their guardians before commencing the therapeutic procedure. I have seen nurse practitioners explaining to cardiac arrest patients about what the treatment entails. They talk about the benefits and possible drawbacks of the treatment schedule and allow an individual to make an informed decision. The consultation process is necessary for positive patient outcomes in the treatment of cardiac arrest. They also discuss potential alternatives to specific therapeutic interventions. Besides, they involve other providers in interprofessional collaboration to implement the therapy. As a result of the effort, the treatment for cardiac arrest using mild therapeutic hypothermia has been effective in eradicating adverse health outcomes, including death.
Clinical practice guidelines are vital for care providers to implement successful interventions in various patient populations. They are a source of evidence-based practice in the treatment of various conditions, such as cardiac arrest. The healthcare organization applied clinical practice guideline, such as mild therapeutic hypothermia in the treatment of patients suffering from the medical condition. The guidelines help professionals in the hospital to make proper decisions regarding the use of the therapy, guide the selection of patients and enhance the actual implementation of the procedure. They have evaluated the efficacy of the process and revealed its effectiveness in the treatment of individuals with cardiac arrest to avoid detrimental outcomes. Besides, evidence from research shows the efficiency of the intervention in various clinical settings for individuals suffering from cardiac arrest.
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