Using the LUCAS 2 Device According to American Heart Association Guidelines: Quality Improvement
Dr. Emilie Dykstra Goris, PhD, RN, Hope College Department of Nursing, Stephanie Mullennix, MSN, RN CEN2, Spectrum Health
The Lund University Cardiac Assist System (LUCAS 2), was created in 2011 to deliver standardized mechanical chest-compressions to patients experiencing cardiac arrest. The device use is increasing in the hospital setting. The American Heart Association Guidelines recommend “against the routine use of automated mechanical chest compression devices to replace manual chest compressions.” The same guidelines suggest that the device should only be used in situations where prolonged chest compressions are anticipated or provider safety is compromised. The purpose of this quality improvement project is to examine whether the device is being used in the hospital setting according to the American Heart Association’s Guidelines. Myra Levine’s nursing conceptual framework of the four conservation principles, particularly conservation of energy, was used for understanding the use of the LUCAS 2 device. This was a retrospective chart review conducted in the Emergency Department of a Magnet designated hospital in West Michigan, using a convenience sample of 62 cardiac arrest cases that occurred since the device was first launched in January through July of 2016. SPSS version 23 was used to determine frequency of device use as well as indications for those uses such as cath lab or other advanced interventions like ECMo or Cooling protocols that might compromise provider safety. The device was used in 45.16% (n=28) of cardiac arrest patients. The device was used with no apparent indication on 14.5% (n=9) of patients. Therefore, there is room for improvement for using this device with the American Heart Association’s guidelines. Limitations include a small, non-representative sample. Further research should be done to generate results that can be generalized to the larger population. Previous research has shown that the LUCAS 2 device can improve patient outcomes, therefore nurses should advocate for the use of the device in accordance with the American Heart Association’s guidelines in order to provide patients with the best care possible.
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