Healthcare is a crucial concern for many, particularly for those at risk of myocardial infarction (MI). Heart disease remains the leading cause of death in the United States, posing a significant threat to public health (Newhouse et al., 2005). According to the American Heart Association (AHA), approximately 356,000 out-of-hospital cardiac arrests (OHCA) occur each year in the United States, underscoring the critical need for effective bystander interventions (AHA, 2020). The importance of bystander CPR in the survival of cardiac arrest patients cannot be overstated. It significantly increases the chances of survival and favorable outcomes, making it essential for nurses to educate patients, families, and the general public on CPR techniques to reduce mortality rates associated with cardiac events.
Change Model Overview
Before the implementation of the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, healthcare professionals lacked a systematic approach to evaluating and implementing evidence-based interventions. Organizations typically did not have structured processes in place to support nurses in developing and assessing nursing interventions, protocols, and policies based on scientific evidence (Newhouse et al., 2005). Prior to evidence-based practice (EBP), healthcare professionals often relied on the advice of more experienced colleagues rather than using the most current research to guide clinical decisions. As recognized by Johns Hopkins University, experience alone is subject to biases and errors, leading to the development of the JHNEBP model. This model provides a powerful, structured approach to problem-solving in clinical settings, specifically tailored to meet the needs of nursing professionals. The JHNEBP model uses a process called PET: Practice Question, Evidence, and Translation, to ensure that the latest research findings are integrated into patient care practices (Johns Hopkins Medicine, 2017).
Practice Question
Step 1: Recruit Interprofessional Team The team of stakeholders will include:
- Emergency Medicine Physician
- EMT – Paramedic
- EMT – Basic/Intermediate
- Registered Nurse
- Family Member
- Randomized Individual (willing to participate)
Step 2: Develop and Refine the EBP Question The research question proposed is: In cardiac arrest patients (P), how does bystander CPR (I) compared to no CPR (C) affect the outcome of a cardiac arrest (O) with no downtime versus extended downtime (T), and how can nurses aid in increasing public awareness and education on CPR?
Step 3: Define the Scope of the EBP This capstone proposal addresses the impact of bystander CPR on cardiac arrest outcomes, focusing on the role of nurses in enhancing public awareness and education. According to the Sudden Cardiac Arrest Foundation, in 2011, approximately 326,200 people in the U.S. experienced out-of-hospital cardiac arrests, with only 10.6% of those treated by emergency medical services surviving (Sudden Cardiac Arrest Foundation, 2014). The American Heart Association projects that by 2030, the prevalence of cardiovascular diseases will increase dramatically, affecting over 23.6 million people (Benjamin et al., 2019). This alarming statistic highlights the growing need for effective bystander interventions like CPR to improve survival rates during OHCA events.