A Multidisciplinary Approach to the Development and Implementation of Best Practices Usng an Innovative Clinical Pathway for the Management of Cardiac Arrest Patients with Cognitive Dysfunction: A Case Study.

Abstract

Out-of-hospital cardiac arrest (OOHCA) affects 20 to 140 people per 100,000 globally with survival rangingfrom 2% to 11% (Meaney et al., 2013). Patients who have survived, but have been left with cognitive impairments due to anoxic brain injury should be offered early identification and initiation of rehabilitation needs during their admission to mitigate the impact of these deficits (Moulaert et al., 2011). Unfortunately, most cardiac survivors do not receive specialized rehabilitation during their acute hospitalization and there are no clinical pathways that currently exist to guide acute care practitioners regarding the appropriate timing of cognitive screens and early rehabilitation interventions. This tertiary care institution designed and implemented a clinical pathway and patient and family education tools, which have systematically improved the identification and treatment ofpatients requiring cognitive rehabilitation. In this paper, the authors discuss the pathway/tool development and use a case study to highlight these interventions.