PICO(T) Questions and an Evidence-Based Approach
When coming up with care practices for the sick, the PICO(T) research structure that expands to Patient population, Issue of Interest or Intervention, Comparison, Outcome, and Time might be utilized to develop an efficient care plan and guarantee that the requirements of the patient are met at the end of the day. In the paper at hand, I will define a practice issue of patients suffering from cardiac arrest, apply the process of PICO(T), identify sources of proof that might offer answers to our research question, give details of the main findings from articles, and describe the significance of those main findings.
Use of the PICO(T) Approach when caring for Patients Suffering from Cardiac Arrest
The exercise issue acknowledged for steadfastness is the requirement of coming up with care exercises, which efficiently manage nervousness in patients suffering from cardiac arrest in acute care hospitals. The question being examined is: how does having a rapid response team affect the number of cardiac arrests in acute care hospitals compared with not having a response team for three months? The acknowledged intervention methodology is patient-centered care or person-centered care (PCC). This methodology is responsive to and respective individual patient values, needs, and preferences and ensures that the patient’s values are utilized in making all clinical decisions. It is the practice of caring for the sick and their relatives invaluable and meaningful manners to the patient himself or herself. It includes involving, informing, and listening to the patient ultimately. The population being investigated is the patients suffering from cardiac arrests with behavioral nervousness systems in acute care hospitals. Since the goal is to examine care exercises that address this issue, only issues linked to acute care hospitals are well-thought-out.
Identification of Sources Evidence
Cardiac arrest and Cardiopulmonary Resuscitation (CPR) model
The study by Neigh et al. (2019) shows that the time taken for pre-intervention arrest is important; as the interval is extended, good neurological recovery, survival, and cardioversion turns out to be increasingly less achievable. The three-phase model of cardiac arrest subdivides the pre-intervention period into three phases. The first 4-5 minute set up the electrical phase, for the period of which counter shocks will probably achieve cardioversion even in the absence of pre-shock CPR (Lenjani et al., 2017). After the next 5-10 minutes of arrest, the circulatory phase, interventions such as chest compressions for effecting circulation, are important to ensure counter shocks produce cardioversion. During the next 10-15 minutes arrest, the patient enters the metabolic phase, during which progressively intense metabolic derangements lead to permanent or protracted organ harm and severe neurological impairment even if the cardioversion is attained.
The time taken for CPR before defibrillator counter shocks is a significant element. Longer intermissions model the protracted cardiopulmonary resuscitation given by onlookers before the paramedics (Yong et al., 2019). On the other hand, it lowers the probability of post-arrest existence with a favorable neurological result. Wide-ranging scrutiny shows that aided air circulation during cardiopulmonary resuscitation following a countersigned cardiac arrest provides little or no endurance or neurological advantage.
Care Workforce-Directed Model
In this model, PCC activities are grounded on education and training on the person-centeredness and empathy of employees. Additionally, the model makes a provision for providing workforce regular feedback for their day-to-day activities. The intervention period is between three and twenty-four months.
Individualized Intervention Model
In this model, intervention activities are conducted based on preferences, abilities, needs, and history of cardiac arrest (Wik et al., 2016). On top of that, trained healthcare professionals with expertise in psychology, geriatric psychiatry, recreational therapy, and social work conduct PCC-based undertakings.
Finding from Articles
Since PCC is a foremost non-pharmacological methodology for treating patients suffering from cardiac arrest, its efficiency is examined by creating scrutiny to the pharmacological methodology of managing behavioral symptoms in patients suffering from cardiac arrest. Generally, pharmacological treatment can be referred to as psychotropic medication of managing symptoms in patients suffering from cardiac arrest. Some of the collective pharmacological treatments include the usage of pharm. According to Lenjani et al. (2017), immediate CPR is important as far as CPR treatment is concerned. CPR helps maintain a constant flow of oxygen to important parts of the body, thus providing an important connection until the patient receives more advanced healthcare assistance. People are advised to call for immediate help if someone collapses near them, and they do not know how to conduct CPR. On top of that, they are advised to start pushing hard and fast on the chest of the victim. Pushing should be done until paramedics, or AED (external defibrillator) arrive.
Progressive care for ventricular fibrillation, a kind of arrhythmia that can result in immediate cardiac arrest, usually consists of the provision of an electric shock via the chest wall to the heart. The process, defibrillation, shortly stops the chaotic and the heart rhythm. Time and again, this procedure normalizes the heart rhythm. Defibrillators are set to acknowledge ventricular fibrillation and propel a shock wave when it is necessary. Research by Wik et al. (2016) has revealed that portable defibrillators are progressively being made available in public places such as centers for the elderly, health clubs, casinos, shopping malls, and airports.
The PCC methodology has demonstrated its effectiveness in addressing the etiology of unmanageable reactions. Contrasting the pharmacological methodology based on addressing the symptoms, the PCC methodology tries to develop solutions to the underlying factors. Study shows that Cardiac Arrest-CPR model exhibit notable contribution as far as improvement in aggressive reaction and clinical practices are concerned. On top of that, the model leads to both fewer readmissions and hospitalizations.
Since this study is inclined to secondary methodology on PCC intervention in managing unusual behaviors in patients suffering from cardiac arrests in acute hospitals, there are many timeframes for the different intervention researches explored. Some studies have a longer duration that ranges from 9 to 24 months, while others last for just several weeks. Based on the PICO(T) structure, a review of the research problem has shown that the structure has significantly backed the marking out of intervention practices. Additionally, it has brought theoretical transparency as far as the reaction of cardiac arrest victims is concerned.
The relevance of Findings from Articles
The study by Yong et al. (2019) was selected since it offers an inclusive description of the PCC-based CPR program of intervention and its probable results. Additionally, it creates a dispassionate assessment of the platform with the pharmacological intervention. The study by Yong et al. (2019) perceived professionals with developed that CPR model significant expertise in managing cardiac arrest is concerned. The strategies framed in the model could be helpful for healthcare professionals in different settings. In their systematic review, Yong et al. (2019) revealed that the CPR model has a remarkable effect on reducing social interaction and increasing nervousness in patients with cardiac arrest. Neigh et al. (2018) were important in the study, as it found that CPR does not only increase anxiety-like behavior. Still, it also decreases social interaction concerning people suffering from cardiac arrest.
In summing up, it is important to develop care practices that are not within pharmacological methodologies for managing nervous-like behavior in patients suffering from cardiac arrest. The PICO(T) structure was applied to determine the intervention tactic of PCC (patient-centered care) was more efficient than the pharmacological tactic by acknowledging evidence’s sources, describing the findings, and providing evidence of the significance of those findings. The articles used have provided relevant, reliable, and precise information to sufficiently examine the efficiency of patient-centered care or person-centered care.
References
Lenjani, B., Baftiu, N., Pallaska, K., Hyseni, K., Gashi, N., Karemani, N., … & Elshani, B. (2017). Cardiac arrest–cardiopulmonary resuscitation. Journal of Acute Disease, 3(1), 31-35.
Neigh, G. N., Kofler, J., Meyers, J. L., Bergdall, V., La Perle, K. M., Traystman, R. J., & DeVries, A. C. (2018). Cardiac arrest/cardiopulmonary resuscitation increases anxiety-like behavior and decreases social interaction. Journal of Cerebral Blood Flow & Metabolism, 24(4), 372-382.
Wik, L., Kramer-Johansen, J., Myklebust, H., Sørebø, H., Svensson, L., Fellows, B., & Steen, P. A. (2016). Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. Jama, 293(3), 299-304.
Yong, Y., Guo, J., Zheng, D., Li, Y., Chen, W., Wang, J., … & Wang, Y. (2019). Electroacupuncture pretreatment attenuates brain injury in a mouse model of cardiac arrest and cardiopulmonary resuscitation via the AKT/eNOS pathway. Life sciences, 235, 116821.