Implementation of Capnography in Post-operative setting to Prevent Postoperative Respiratory complications
Introduction
According to the Academy of Medical-Surgical Nurses, evidence-based practice (EBP) is the conscientious application of the current best evidence in making decisions regarding the care of the patients. On the other hand, the National Council of State Boards of Nursing defines EBP as the process of integrating the best research with clinical experience and the values of the patients. EBP assists nurses in evaluating research, clinical practice guidelines, and other materials in the nursing field as this aids in applying the findings in the provision of high-quality care to the patients.
There are importances and benefits of EBP in the nursing field. First, EBP has introduced significant changes in the nursing field. This has enabled the focus of coursework to not only increase the nurses’ overall knowledge but also on professional accountability. Second, the expansion of EBP has allowed nurses to place more emphasis in the nursing research. Some of the advantages of EBP include improved patient outcomes, superior nursing skills, and lower costs of healthcare. For instance, EBP focuses on raising the overall quality of healthcare, and this has resulted in improved health of the patients. Besides, application of patient-centered care approach helps in eliminating unnecessary costs for treating patients with chronic illnesses as well as reducing expenses for healthy patients. This paper will identify an essential clinical issue among postoperative care for the patients who have undergone surgical anesthesia, and provide the most appropriate recommended change of practice.
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Clinical Issue
Respiratory depression is a severe complication in the postoperative period. The available clinical practice guidelines for post-anesthetic care from the American Society of Anesthesiologists (2016) only recommend the monitoring of oxygen saturation and airway patency as solutions to evaluate the postoperative respiratory function and this is not sufficient enough for anesthesiologists to provide timely assessment of the patients. The pulse oximetry commonly used in clinical settings has reduced sensitivity in the detection of hypercarbia and hypoventilation especially in cases involving administration of supplemental oxygen.
The clinical question used is “In post-operative patients, is the implementation of capnography more effective in preventing respiratory complications as compared to pulse oximetry for a 5-day period?” PICOT is a synonym for patient, intervention, comparison, and outcome. In this case, the patient/population is postoperative patients with respiratory complications, intervention is capnography monitoring, the comparison is pulse oximetry, and time is five days. There are different types of PICOT questions such as therapy, diagnosis, prognosis, and etiology. Therapy involves questions based on treatments for achieving the desired outcome. Some of this treatment options include the use of medications, change in diet, counseling, and surgical interventions. The PICOT question used in a therapy question whose treatment is based on the use of capnography which is surgical intervention. The therapy based PICOT question is employed because it allows for easy comparison of two interventions. The PICOT question compares the efficacy of capnography with pulse oximetry in PACU clinical settings. The available evidence shows that capnography is more effective than pulse oximetry because it overcomes most of the limitations associated with pulse oximetry.
Background
The reduction of postoperative complications in PACU environments is of great concern due to its impacts on mortality and morbidity as well as on healthcare costs. Respiratory complications after surgical operations is an umbrella encompassing airway obstruction, hypoventilation, and hypoxia. Failure to implement effective interventions in PACU clinical settings results in complications such as pneumonia, respiratory arrest, and reintubation (Geralemou et al., 2016). Such complications mainly arise from anesthesia, residual neuromuscular blockade, type of surgery conducted on the patient, the patient’s risk factors and breathing difficulty due to inadequate pain control. The application of capnography has garnered more support in clinical settings due to its effectiveness in curbing respiratory depression symptoms for procedural sedation.