Posted: April 2nd, 2015

Review of research article

Title of article: Emergency nurses’ current practices and understanding of   family presence during CPR by Madden & Condon (2007).

Purpose of the Article

The article reports the finding of a study that sought to examine the practices and understanding of emergency nurses working at Cork University Hospital, Ireland on family witnessed resuscitation (FWR). The authors did not identify a research question; they only stated the purpose of their study.

Author’s Credentials

The study had 2 authors, Eilis Madden and Carol Condon. Eilis Madden has the following academic credentials MSc, BSc, RGN, DipMang, HDipA and E while Carol Condon has an MSc, BNs, RGN, RNT, and ENB 100 NFESC. Both have a masters degree which prepares one to be able to undertake research in the nursing field. Whilst they are not experts in emergency medicine, their educational preparation has equipped them with the necessary knowledge and skills to carry out nursing research.

Research Method

The authors employed a quantitative descriptive research design. The study was descriptive because it sought to document the prevalence and nature of health-care related practices and knowledge. It was quantitative because quantitative data was gathered objectively in a systematic, organized, and controlled manner to permit the findings to be inferred to other populations (Boswell & Shannon, 2012, p. 204; Hesse-Biber & Leavy, 2010, p. 365). The findings on the various variables were also summarized numerically (Lodico, Spaulding, & Voegtle, 2010).

Data Collection

Data was collected on the demographic variables of the study respondents, knowledge of the nurses on FWR policies and practices, the nurses preferences on policy development for FWR, and barriers and facilitators to FWR. The data was collected at the emergency department of Cork University hospital. A survey questionnaire consisting of 15 close-ended questions was used to collect the data.

Sample Selection

The study population consisted of emergency nurses with at least six months nursing experience working in a busy level I trauma emergency department. The sample was selected via convenience sampling.

Results

Demographic variables: Most of the respondents were female (83.3%) aged 30-40 years who were employed as staff nurses. Over 50% of the respondents had a working experience of 4-10 years. On their qualifications, 41.6% had degrees, 38.2% diplomas, and 1.1% masters in nursing.

Knowledge of policies: 65% of the nurses reported that hospitals had no policies on FWR.

Preferences and practices of the nurses on FWR: Nearly three-quarters of the nurses (74%) reported they preferred a written policy on family presence during CPR. Two-thirds (58.9%) reported they allowed families to be present during CPR despite the lack of a written policy. Only 2.2% of the respondents were against enactment of a written policy on FWR.

Barriers and facilitators to FWR.

Barriers: More than half (58%) of the respondents stated that FWR may cause conflicts amongst members of the emergency team, fifty percent believed FWR increases stress levels emergency team members, thirty five percent cited fears of litigation as a barrier, and twenty seven percent fear of interference of CPR by family members.

Facilitators: The most cited facilitators were enhanced understanding by health professionals of benefits of FWR (88%), presence of written policies on FWR (88%), and consensus amongst members of the emergency team (94%).

Conclusions

The authors concluded that the findings of the study, like those of prior studies, indicated the need for enactment of written policies and guidelines on FWR so as to meet the needs of patients, their families, and staffs through safe, consistent, and caring FWR practices.

Recommendations for Further Research

The quantitative nature of the study did not allow in-depth exploration of the nurses perceptions. A follow-up study utilizing a qualitative design was thus recommended.

Application

The study identified possible barriers and facilitators to FWR. The findings have also reiterated the need for the development of written policies on FWR. I will use these findings to inform my nursing practice in relation to FWR and to advocate for written policies on FWR.

Personal Reflection

The process utilized in searching and summarizing the research article will be reflected upon using the Learn framework for reflection. Learn is a mnemonic for the following 5 steps of the reflective process: look back, elaborate, analyze, revise, and new trial (Rideout, 2001, p. 131).

Looking Back

I will reflect on the experience of searching and summarizing an article on the evidence-based practice of FWR.

Elaboration and Description

In researching the article, I first identified 3 researchable nursing problems: patient falls, FWR, and diabetic wound care. I searched for articles on these topics from both medical and nursing databases such as CINHAL, pubmed, and ovid. I was disappointed initially because I could not retrieve full articles because they were either password protected or the sites required you to pay a specified amount for full access. Another problem was that most of the articles retrieved were systematic or meta-analytic reviews. I settled for FWR because it had the most free and recent articles. I narrowed the search terms to family presence during resuscitation and family witnessed CPR. This enabled me to retrieve the Madden and Condon article. I was elated to finally retrieve an article that met the requirements of the assignment.

Analysis of Outcomes

I was able to access an article that met my needs. The process was, however, tedious and time consuming. The main problem was that I had not refined my search terms hence my internet searches retrieved many irrelevant articles. I was also downloading articles without reading their abstracts hence I ended up with many unsuitable articles.

Revision

In future, I will read the abstracts of all articles first so as to establish their relevance to my topic. I will also refine my search terms as appropriate and limit the number of words so as to retrieve useful articles. I will also conduct an open internet search since it also permits the retrieval of journal articles online.

New Trial

I employed my new internet search strategy on the same topic and I was able to retrieve 5 relevant articles.