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| Author | Joanna Mifsud |
| Abstract | Witnessed Resuscitations refers to the opportunity for relatives to be in the resus room where a resuscitative event is happening on a loved one. The aim of this study was to explore views of all full-time doctors and nurses working in the local Accident and Emergency Department, on the issues of witnessed resuscitations. The main objectives of this study were to identify the meaning of witnessed resuscitation amongst the professionals, to explore the difference in perceptions between the professionals on such an issue, to identify the implications of witnessed resuscitations on staff and to explore the feasibility of introducing such a system in the local A&E Department. By using a postal survey, this study explored nurses and doctors views on witnessed resuscitations at the Accident and Emergency department, which although it is still not a confirmed local practice, is still an issue of great debate amongst the A&E practitioners. The study sample consisted of 33 nurses and 30 doctors, all working full time in the local emergency department, which yielded to a response rate of a 72%. The self-designed questionnaire used to collect data consisted of both closed and open-ended questions. Various findings were revealed throughout the findings and the discussion chapters. The major findings of this research study were that the majority of health care professionals are aware of what witnessed resuscitation entails (n=56) however, discuss issues of professional competence, knowledge and education on such phenomenon. There is no clear-cut decision if the professionals agree (n=32) and do not agree (n=31) with witnessed resuscitations, as findings are very debatable amongst the sample. However, findings also suggest that if local practitioners are given adequate knowledge and support, look forward for change in practice and then maybe accept the introduction of witnessed resuscitation in practice (n=29). The majority of them (n=31), would prefer to have 2 relatives in the resuscitation room to support each other and to handle the other relatives better after resuscitation, whether it might be successful or not. Following the literature review and after carrying out the research study, the following recommendations for further research and practice could be suggested. 6.2 RECOMMENDATIONS FOR PRACTICE To increase the familiarity of the issues of witnessed resuscitations through talks and creation of discourse on the issues involved, as well as to organise in-service and inter-departmental courses and workshops, possibly through the Malta Emergency Nursing Association (MENA) to enhance confidence in practice. The aim of this will be to identify possible negative issues, to discuss and out-line potential problems, which might hinder the initiation of this practice in the system, and to increase confidence in practice in those professionals who would still feel uncomfortable with the introduction such practice in the system. This includes also feed back from other members of the multidisciplinary team who might not be accustomed to such practice, however they are still part of the resuscitation teams eg: anaesthetists and radiographers. To create an opportunity to train a group of experienced nurses or doctors who would want a specialised role to care for relatives during and after resuscitations. This could be done through the collaboration of Practice Development Nurses and Psychologists. 6.3 RECOMMENDATIONS FOR RESEARCH Organisation of an Action Research study. To carry out a longitudinal study over at least 1-2 years to enable two relatives entering resuscitations on a voluntary basis. Evaluation after six months will entail retrospective data collection from relatives who witnessed resuscitations, from patients who survived resuscitations and from nurses and doctors. The aim of this evaluation will be to evaluate the effectiveness of this service and to explore the perceptions of all the parties involved. In addition to that, to evaluate the feasibility of the presence of two relatives in the resuscitation room and how it might have effected the resus team. The evaluation will serve to either stop witnessed resuscitations, to decrease from two relatives to one or to adjust for better quality of care with or without relatives involvement in the resus room. Changes made after evaluation are then re-evaluated after another 6 months and acted upon accordingly, in the aim of enhancing research based safe practice and the delivery of effective care to patients and relatives. |
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