Personal Protection of Nurses During Resuscitation

Resuscitation is relatively new to the world of evidence-based practice (Moule & Albarran, 2009, p. 2). Unfortunately, it is founded on a limited body of scientific evidence. The existing evidence presents the basis for . Modern cardiopulmonary resuscitation has remained mainly the same since its introduction. In fact, the resuscitation techniques, CPR in particular, attract much less additional research than other areas of medical services. This tendency results in the lack of actions aimed at modernizing and improving current emergency medical practice. The enhancement of resuscitation procedure has a huge potential for preventing an extensive amount of deaths. Therefore, further research should be encouraged, as considering resuscitation activities those that suggest no improvements or alternatives is the wrong belief that costs millions of lives. Studying the existing evidence of the best resuscitation practices is of vital importance for any healthcare giver eager to provide the best treatment of his/her patients in emergency situations. International collaboration is also of paramount importance for creating the guidelines that can standardize the management approach to cardiac arrests and other on the exchange of experience in saving adults and children (Moule & Albarran, 2009).

The responsibilities of nurses are directly related to eliminating the conditions putting the life and well-being of the patient at risk. Therefore, nurses should know how to deliver appropriate treatment and perform resuscitation procedures. The responsibilities of nurses include performing basic cardiac life support measures and maintaining the appropriate certification. Nurses should have the knowledge of CPR and use it effectively. The continuous refreshing of skills is of vital importance, as the abilities to perform appropriate procedures can become lower to critical levels if not used often. Many researchers suggest the methods of enhancing the appropriate attitudes of nurses to personal protection during resuscitation. Dwyer and Williams (2002) emphasize the essential role of educating nurses about the significance of providing appropriate resuscitation procedures. Makinen, Niemi-Murola, Kaila, and Castren (2009) support this view and consider intensive education able to reduce anxiety among the nurses.

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Besides the knowledge about the resuscitation procedures, nurses need to be aware of precautions necessary for protecting them from possible transmission of diseases. Unprotected resuscitation is dangerous, as infections are one of the most important causes of morbidity and mortality related to clinical procedures (Vaz et al., 2010). Therefore, knowledge about appropriate personal protection is required. Pieces of protection equipment include mouthpieces, pocket resuscitation masks with one-way valves and other ventilation devices (Pankhurst & Coulter, 2009). Delivering resuscitation with the help of such equipment presents a safe alternative to (Pankhurst & Coulter, 2009, p. 85). By using such equipment, the caregiver prevents exposing his/her mouth and nose to the patients oral and respiratory fluids. It helps to prevent potential harm caused by the procedure to the caregiver, including being infected.

Certain factors affect the nurses compliance with the standards of using personal protection equipment during resuscitation. Nichol et al. (2013) studied such factors and identified availability of appropriate equipment, regular training and fit testing, and organizational support for worker health and safety as the main contributors to ensuring personal protection of nurses (p. 8). Ganczak and Szych (2007) also emphasize the importance of providing the availability of appropriate equipment for eliminating the risks of noncompliance with personal protection standards during resuscitation among nurses.

Arab countries are currently investing much money and efforts in improving their health care systems and ensuring the effectiveness of medical services. Personal protection of nurses is one of the issues that are of vital importance for providing the safety and efficacy of medical interventions. Sreedharan, Muttappillymyalil, and Venkatramana (2011) conducted a study aimed at revealing the level of knowledge about standard precautions among nurses in one of the Arab countries. The researchers gained the results that demonstrate that most nurses in the hospital in Ajman, the United Arab Emirates, are aware of standard precautions. However, the level of knowledge about the guidelines and implementations related to these precautions appeared to be lower than the appropriate (Sreedharan, Muttappillymyalil, & Venkatramana, 2011). The findings of this study help to understand the necessity of conducting further research on knowledge about personal protection during resuscitation and launch appropriate training programs.

Medical services in Saudi Arabia are largely funded by the government. The quality of health care in the country has been improved greatly during the last several decades (Almalki, Fitzgerald, & Clark, 2011). Though Saudi Arabia has achieved significant results in modernizing the health care system in a short period, the medical services in the country still need to overcome many challenges, which require the enactment of appropriate laws and policies (Almalki, Fitzgerald, & Clark, 2011). As in any country, nurses comprise a huge sector of the health care system in Saudi Arabia, and, therefore, the use of the protection equipment during resuscitation by nurses belongs to the vital issues that need to be properly assessed and improved if needed.

Critical Literature Review
Search Strategies
A literature search was conducted to that provide information about personal protection equipment of nurses in Saudi Arabia. Three major databases were used for literature search, including Google Scholar, CINAHL, and Medline. Such search terms as personal protection, protection equipment, resuscitation, nurses, Saudi Arabia, and emergency department were used. As there is a very limited amount of literature about the research topic, the term Saudi Arabia was further substituted with the terms Middle East and worldwide. The search was limited from the period of 2005 to 2015. Only articles published in the English language were included.

By using the initial criteria, 30 articles providing information related to the research topic were found. The search was condensed, and ten articles were included while twenty articles were not included because they were not relevant to the research aim. The reference lists of the selected articles were hand searched to extend the search. It resulted in 5 more articles to be included in the review process. Overall, 15 articles were selected to be reviewed.

Summary of Reviewed Literature
The literature search has revealed that there is a very limited number of studies investigating the research topic. It is rather difficult to find a study investigating the personal protection of nurses during resuscitation in a major emergency department in Saudi Arabia. However, there are many studies related to the topic. Various studies investigate the specifics of the resuscitation procedures, the risks related to the procedure, and the importance of the usage of personal protection equipment in emergency departments in Saudi Arabia and worldwide.

. (2008) investigated knowledge and attitudes towards cardiopulmonary resuscitation among students in one of the universities in Saudi Arabia. This study sheds some light on the specifics of resuscitation in the country, as it shows how well the future specialists are prepared for such type of activities. The researchers conducted a cross-sectional survey among King Saud University Students in Riyadh, Kingdom of Saudi Arabia. The results showed that though attitudes to cardiopulmonary resuscitation (CPR) were positive, the knowledge about the topic was insufficient. The findings of the study demonstrate that more effort should put in the improvement of CPR skills among the potential healthcare givers in Saudi Arabia.

Alanazi (2012) conducted a study aimed at revealing the common problems faced by the members of emergency departments in Saudi Arabia. The investigation was based on the usage of the questionnaire that included eight different commonly experienced barriers. 140 paramedics from three different regions (Jeddah, Riyadh, and Dammam) of Saudi Arabia participated in the research. The results revealed that certain barriers put a threat on the efficiency of emergency interventions. Therefore, the authorities and administration should put more effort in eliminating the defined barriers. Training and education were also suggested as the essential part of the activities aimed at providing positive changes.

Gouda, Al-Jabbary, and Fong (2010) investigated the specifics of delivering resuscitation in Saudi Arabia in cases when the policy addressing patient care at the end of life should be addressed. The researchers emphasized that there is a lack of studies investigating the compliance of physicians in Saudi Arabia with Do Not Resuscitate (DNR) policy. A cohort study of data was conducted at King Abdulaziz Medical City. The results demonstrate that the compliance with the policy is relatively poor and proves the fact that the advance directive is not a common practice in Middle Eastern countries.

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