504 D1 Assignment: Answering Clinical Question, Intervention

5.1 case study.
You are caring for an infant 4 days after cardiac surgery in the pediatric intensive care unit. Platelets and albumin were administered the night before because of the infant’s abnormal clotting profile. In consultation with the healthcare team, you remove the pulmonary artery catheter. You notice continuous ooze from the site and a marked deterioration in the patient’s condition. Cardiac tamponade is diagnosed, and the patient requires a reopening of the sternotomy and removal of 200 mL of blood from the pericardial sac. At the end of your shift, you wonder how rare such a complication is in this patient population and decide to look at the literature.
 
What the Literature Says: Answering a Clinical Question In Clinical Scenario 5.1,
The clinical question you may want to ask is: In infants who have had cardiac surgery (P), how often does removing pulmonary artery catheters (I) influence cardiac tamponade (O) within the first week after surgery (T)? In your search, you find a case study that describes a similar complication to one you have just experienced: Johnston and McKinley (2000). The article is a case report of one patient who experienced cardiac tamponade after removal of a pulmonary artery catheter. The article focuses on describing the pathophysiology of tamponade. The report states that this complication occurs with a frequency rate of 0.22%. The authors give details of their experience with a single patient and provide some recommendations for limiting the potential for bleeding complications in this patient population. You take a copy of the paper to your unit for discussion. You realize that this one case study is not enough to make practice change, so you search for stronger studies (e.g., controlled trials) to assist in developing an addition to your unit protocol manual to create awareness of possible complications arising from removal of monitoring catheters and how to prevent such complications.
 
Melnyk, Bernadette; Fineout-Overholt, Ellen. Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (Page 108). LWW. Kindle Edition.
 
Direction:
Review the facts of the case and discuss how you would find the evidence needed to address the clinical question. 1 page APA format 6th edition. Need 3 references.