ADULT RESUSCITATION

What are the attitudes and opinions of emergency nurses regarding family presence during adult resuscitation?

What are the attitudes and opinions of emergency nurses regarding family presence during adult resuscitation?

Introduction to Evidence Based Practice

The aim of this assignment is to demonstrate an understanding of the process of critical appraisal and its contribution to Evidence Based Practice (EBP). Drawn from my professional experience this assignment will initially focus on a topic of interest and the development of a research question suitable for enquiry. Papers selected will be critically appraised using a systematic approach. The appraisal will be summarised and implications considered informing future practice and possible research opportunities.

According to the Nursing and Midwifery Council (NMC) code of professional conduct, health care professionals have a responsibility to deliver care based on best practice, current evidence and - where applicable - validated research (American Association of Critical-Care Nurses 2004, 98). In recent years, interest in research related to nursing care has grown and nurses have been encouraged to ensure that their practice is based on research evidence rather than tradition (AACN Practice Department Editors 2007, 98). This is further reinforced by Ardley (2003, 99) who believe that nurses have a personal responsibility to remain updated on 'current best practice', which includes the ability to critically evaluate new research effectively. In order to develop scientific knowledge that help nurses to give evidence based health care nursing research is important. Evidence based nursing predisposes research. However, Sacket (2006) argues that evidence provided by research does not, necessarily mandate a change in practice: the whole purpose of EBP is to use available research to inform practice, and as a result of good judgement by practitioners ensure that healthcare professionals we do what is best by our patients.( Badir 2007, 99)

In my experience health care professionals who work in Emergency Department's (ED) are regularly faced with the demanding and stressful role of treating and caring for the dying patient and their distressed relatives, often following traumatic accidents or a sudden illness. One increasingly common practice that regularly tests emergency nurses' abilities and about which they have conflicting views is 'family witnessed resuscitation' (Belanger 1997, 98). Although becoming increasingly common and stimulated by worldwide debate this phenomenon remain an area under researched and a source of contention amongst emergency nurses and doctor's alike (Branswell 2002, 98).

Indeed my own interest in the subject of family witnessed resuscitation has been provoked by incidences that I have observed in clinical practice. The clinical area in which I work (ED) lacks formal guidelines on witnessed resuscitation and it is standard policy to exclude family members from the resuscitation room. This however is not to say that relatives are refused if they indicate a strong desire to do so, but that medical and nursing staff do not proactively suggest the option to be present to them. Growing evidence suggests that relatives and increasing numbers of healthcare professionals feel that this is inadequate practice (Canadian Association of Critical Care Nurses 2005, ...