Location
Virtual Conference
Start Date
12-8-2022 1:05 PM
End Date
12-8-2022 1:25 PM
Description
The Joint Commission (TJC) published new performance standards on Post Cardiac Arrest (PCA) care that went into effect on Jan 1, 2022. The new standards encourage hospitals to review and synthesize current scientific literature on Post Cardiac Arrest Syndrome (PCAS) and analyze current hospital practice. Following a review of the evidence, hospitals are guided to create a multidisciplinary protocol and education that facilitates training of personnel, implementation of the evidence into clinical practice, data collection, and case review processes. The intent of the standard is to bring hospital based clinical practice in line with the established standards to improve patient survival.
The Providence Mission Hospital (PMH) Resuscitation Committee (RC) reviewed the standards and determined that some of the performance standards were met – specifically-resuscitation services available, RC collected/analyzed performance of cardiac arrest, and Targeted Temperature Management protocol (TTM). However, the RC also identified a need to review the evidence related to PCAS and create a comprehensive post cardiac arrest care/neuro prognostication PCAS Protocol with a strong multidisciplinary and scientific foundation. The RC proposed an evidence-based project (EBP) using the Johns Hopkins EBP Model and involving the multidisciplinary team of physicians (Emergency Department {ED}, Pulmonary/Neuro Intensivists, Neurologists, Cardiologists), nurses (Rapid Response Nurse, ED, & Intensive Care Unit {ICU} staff/leaders), and ancillary staff (Respiratory/Pharmacy). The RC sought and received approval for the EBP from the Chief Nursing Officer.
The PCA leadership team (ED Physician, Intensivist, Clinical Nurse Specialist [CNS]-Neuro and Cardiac, & ICU Nurse Manager [NM] met and developed a plan for the PCA EBP. Physicians and Nurses from the ED, ICU, Neurology, and Palliative Care were sought as members. The leadership team created nine small teams (multidisciplinary) with assigned PICO questions and references for review. In total, 23 PICO questions with assigned references (170 articles) were reviewed by nurses and article summaries placed into evidence tables for presenting at the small group meetings. Physician members also reviewed pertinent articles. Coordination and communication of the project occurred during a large group meeting (3/2/2022) for all members introducing the scope of the project, nine smaller team meetings where the literature reviews were presented and interventions specific to the area were agreed upon (3/2/2022-4/6/2022), and a 2nd large group (4/8/2022) meeting where consensus on target goals, assessment/diagnostics, and interventions for inclusion in a hospital based PCA Care Multidisciplinary Protocol was achieved.
The major sections of the PCA Protocol includes Emergent Priorities in the 2 Hours; Cardiac management, Pulmonary and Sedation management, Neuro management (Neuro Assessment, Cerebral Edema, Seizures, Neuroprognostication), ICU Management Priorities, and Team Based Care-Bundles of Care and Shared Decision Making. The PCA multidisciplinary protocol received approval by the medical staff committees. Education was completed for the staff and quality indicators for post cardiac arrest care are being collected and reviewed (100% review of all cardiac arrests in the ED/In-hospital on a quarterly basis by the RC).
The successful development of the PCA protocol was achieved by creating an inclusive team gaining insight from the evidence-based literature through review and discussion and achieving consensus on the management of this critical population.
Event Type
Podium Presentation
Keywords:
california; mission viejo
Recommended Citation
Bader, Mary Kay; Wavra, Teresa; Qureshi, Tauseef; Cline, Jon; and Andersen, Marne, "An EBP Approach to Managing Post Cardiac Arrest Interdisciplinary Care" (2022). 2022 Southern California Nursing Research Conference. 10.
https://digitalcommons.providence.org/socal_nursing_conference_22/2022/day1/10
Included in
An EBP Approach to Managing Post Cardiac Arrest Interdisciplinary Care
Virtual Conference
The Joint Commission (TJC) published new performance standards on Post Cardiac Arrest (PCA) care that went into effect on Jan 1, 2022. The new standards encourage hospitals to review and synthesize current scientific literature on Post Cardiac Arrest Syndrome (PCAS) and analyze current hospital practice. Following a review of the evidence, hospitals are guided to create a multidisciplinary protocol and education that facilitates training of personnel, implementation of the evidence into clinical practice, data collection, and case review processes. The intent of the standard is to bring hospital based clinical practice in line with the established standards to improve patient survival.
The Providence Mission Hospital (PMH) Resuscitation Committee (RC) reviewed the standards and determined that some of the performance standards were met – specifically-resuscitation services available, RC collected/analyzed performance of cardiac arrest, and Targeted Temperature Management protocol (TTM). However, the RC also identified a need to review the evidence related to PCAS and create a comprehensive post cardiac arrest care/neuro prognostication PCAS Protocol with a strong multidisciplinary and scientific foundation. The RC proposed an evidence-based project (EBP) using the Johns Hopkins EBP Model and involving the multidisciplinary team of physicians (Emergency Department {ED}, Pulmonary/Neuro Intensivists, Neurologists, Cardiologists), nurses (Rapid Response Nurse, ED, & Intensive Care Unit {ICU} staff/leaders), and ancillary staff (Respiratory/Pharmacy). The RC sought and received approval for the EBP from the Chief Nursing Officer.
The PCA leadership team (ED Physician, Intensivist, Clinical Nurse Specialist [CNS]-Neuro and Cardiac, & ICU Nurse Manager [NM] met and developed a plan for the PCA EBP. Physicians and Nurses from the ED, ICU, Neurology, and Palliative Care were sought as members. The leadership team created nine small teams (multidisciplinary) with assigned PICO questions and references for review. In total, 23 PICO questions with assigned references (170 articles) were reviewed by nurses and article summaries placed into evidence tables for presenting at the small group meetings. Physician members also reviewed pertinent articles. Coordination and communication of the project occurred during a large group meeting (3/2/2022) for all members introducing the scope of the project, nine smaller team meetings where the literature reviews were presented and interventions specific to the area were agreed upon (3/2/2022-4/6/2022), and a 2nd large group (4/8/2022) meeting where consensus on target goals, assessment/diagnostics, and interventions for inclusion in a hospital based PCA Care Multidisciplinary Protocol was achieved.
The major sections of the PCA Protocol includes Emergent Priorities in the 2 Hours; Cardiac management, Pulmonary and Sedation management, Neuro management (Neuro Assessment, Cerebral Edema, Seizures, Neuroprognostication), ICU Management Priorities, and Team Based Care-Bundles of Care and Shared Decision Making. The PCA multidisciplinary protocol received approval by the medical staff committees. Education was completed for the staff and quality indicators for post cardiac arrest care are being collected and reviewed (100% review of all cardiac arrests in the ED/In-hospital on a quarterly basis by the RC).
The successful development of the PCA protocol was achieved by creating an inclusive team gaining insight from the evidence-based literature through review and discussion and achieving consensus on the management of this critical population.
