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Methodology
The conceptual model of the research is a cross-sectional examination of databases from multiple healthcare institutions. The research design is exploratory in nature. By examining the databases of hospitals throughout the United States and Canada, the researchers will highlight the outcomes of neonates with heart and lung failure in various health care settings. The hospitals will be tabulated according to their inventory of ECMO machines and related devices such as VADs. Technology is only one of the components or variables taken into account for this research. Researchers also tabulated the areas of specialization of the medical staff, to show how many staff members specialized in the use of ECMO on infant populations. When the data was aggregated, it was compared with data related to patient outcomes. In particular, a total of 2, 457 neonates were examined over the course of an eight-year period. This sample population was randomized. The randomized patient population was examined for pre-intervention and post-intervention prognoses.
Results
Results show that in health care organizations employing no fewer than one specialist in ECMO delivered to neonates, the patient outcomes were 79% better than those in hospitals with only partial ECMO facilities. Moreover, the technologies available to perioperative practitioners had a direct and significant relationship with patient outcomes. Neonates receiving ECMO -- either VV or VA -- using state of the art equipment, fared 85% better than neonates that did not receive the state of the art interventions. In 23% of the cases, patients died due to complications with the ECMO process itself.
Limitations
This study is limited in several ways. For one, it is not an experimental research design. Exploratory in nature, the current research is valuable for highlighting areas of weakness in both...
The limitations of the study also include low external and internal validity. The patients were not separated into groups related to extraneous variables including race, socio-economic class of family, gender, and other conditions that may have impacted the outcome of the ECMO intervention. However, the current research does highlight what healthcare centers need to do in order to improve patient outcomes.
Perioperative Nursing Implications: How this study affects perioperative nursing
The implications for perioperative nursing are tremendous. Nurses need to understand the limitations of their health care institution in providing properly for all patient populations. When the patient population in question is neonates, the need for specialists and for research-based practice becomes even more important. Because more research needs to be done in some areas of delivery of service, such as providing neonates and children with VADs, this research can help raise awareness. Health care administrators should devote funding to hiring specialists and the equipment necessary for treating the conditions for which ECMO is indicated.
References
Blume, E., Naftel, D.C., Bastardi, H.J., Duncan, B.W., Kirklin, J.K., Webber, S.A. (2006). Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices. Circulation. 2006; 113: 2313-2319
"An Introduction to Extracorporeal Membrane Oxygenation (ECMO)" (n.d.). Retrieved online: http://www.perfusion.com/cgi-bin/absolutenm/templates/articledisplay.asp?articleid=1807
"Introduction to ECMO for Parents," (n.d.). Retrieved online: http://lane.stanford.edu/portals/cvicu/HCP_CV_Tab_1/ecmo_for_parents.pdf
Thakar, D.R., Sinha, A.C., & Wenker, O.C. (2001). Concepts Of Neonatal ECMO . The Internet Journal of Perfusionists. 2001 Volume 1 Number 2.
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