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An Evaluation of the Impact of Resternotomy Preparation Training for Bedside Nurses and Advanced Care Providers for Post-Cardiac Surgery Arrests

Bullins, Charles M. (2018) An Evaluation of the Impact of Resternotomy Preparation Training for Bedside Nurses and Advanced Care Providers for Post-Cardiac Surgery Arrests. [Dissertation]

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Abstract

The survival rate for post cardiac-surgery arrests has been shown to be higher than in-hospital cardiac arrests (50% vs. 24.8%). Success is attributed to the high incidence of three reversible causes: ventricular fibrillation, cardiac tamponade, and postoperative hemorrhage. A growing body of cardiac surgery literature suggests the need for a modified resuscitation protocol utilizing early resternotomy with internal cardiac massage and preparation training for all providers. This study evaluated the resuscitation practice trends and the impact of resternotomy preparation training and compared patient outcomes to those treated with standardized resuscitation compared to those treated with resternotomy. The researchers found that semiannual resternotomy preparation training effectively decreased time-to-resternotomy by three minutes, improving 24-hour survival to 76.9% among resternotomy patients compared to 44.4% pre-training, and improved survival-to-discharge to 23.1% post-training compared to 0% pre-training. The researchers also identified a high incidence of arrhythmias as the primary cause for post-operative cardiac arrest (45.5% for resternotomy patients and 56.8% for non-resternotomy patients) and recommend modification to current resuscitation practices. Finally, the study identified a need for improved management of post-resuscitative complications such as anoxic brain injury and respiratory failure. Charles M. Bullins II, MSN, AGACNP-BC Department of Nursing, 2018 Radford University

Item Type: Dissertation
Subjects: R Medicine > RT Nursing
Divisions: UNSPECIFIED
Depositing User: Charles M. Bullins II
Date Deposited: 14 Sep 2020 16:28
Last Modified: 14 Sep 2020 16:28
URI: http://wagner.radford.edu/id/eprint/439

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