Introduction
The 21st century economy requires people to spend most of their time in offices, which limits opportunities for physical exercise. The lack of normal physical activities such as walking contributes a great deal to heart dysfunctions and other related matters. Although heart diseases affect people of all ages, the elderly are at more risk of developing heart complications in comparison with the younger generation. One of the most effective heart care that have proven success in the medical world is the use of implantable cardioverter defibrillator (ICD). The device helps regulate the human body functions, thus reducing chances of heart failure (Russo, 2011).
Key elements of the Article
The article analyzes the ICD deactivation process by stating various issues that surround the process. The author of the article presents his ideas in a logical way, thus making the paper a reference material for clinicians. He analyzes other researcher works and presents the information systems for clinical use. In his article, he defines ICD as a life-supporting device that regulates the rate of heartbeats in a human body (Russo, 2011). The device provides painful shocks that counteract abnormal body functions, thus restoring the heart’s functions to normal. However, at the time of death, the device can make the patients last minutes painful unnecessarily if not deactivated in time. The discussion on the deactivation of ICD devices before the time of death is a rather controversial issue in the medical world. Deactivating the device helps reduce complications at the time of death, but many health care providers find it hard to disconnect or discuss with the patients the reasons for ICD deactivation (Russo, 2011). On the other hand, patients prefer to experience the pain of shocks rather than have the device deactivated.
Factors That Delay the Deactivation Process
Patients have a negative attitude towards the deactivation of the ICD device. The patient’s attitude towards the deactivation of ICD results from the patient’s lack of knowledge of the functionality of the device. Healthcare providers do not equip the patients with relevant information during the implantation of the device, thus making it hard for the patient to agree or even initiate the deactivation process. Healthcare providers assume that patients are fully aware of the limits of the device and the implications of having an active ICD device at the time of death. The misconception between the care provider and the patients delays the deactivation of the device (Mabry, 2013).
Healthcare providers’ unwillingness to deactivate the ICD devices causes the delays in the deactivation process as well. The primary goal of health care providers is to offer all the possible solutions to a patient’s condition. The idea of ending a life is quite overwhelming on health care providers because their primary role is to preserve life. Initiating the deactivation process indicates loss of hope on the care provider’s part, which can affect the health of a patient negatively. As a result, many care providers prefer discussing alternative care with their patients rather than initiating the deactivation talks. Most health care providers lack relevant information and knowledge concerning the ICD devices. The knowledge deficiency makes it hard for the practitioner to initiate deactivation discussions with the patients (Russo, 2011). In addition, many care providers do not know how to deactivate the device effectively. The fear of complicating issues further through the deactivation process makes it hard for health care providers to agree to the deactivation request.
The legality of ICD deactivation is another reason that health care providers remain reluctant to the course. Unlike other life support mechanisms, the information available on ICD devices is quite limited (Mabry, 2013). In addition, discussions regarding the deactivation of ICD’s are uncommon in hospitals. The unwillingness of people to discuss the deactivation of ICD devices makes it hard for healthcare providers to establish the legal nature of the process. As a result, practitioners waste a lot of time consulting with psychiatrists and ethics departments to determine the legality of the deactivation process. The unnecessary evaluations cause delays, and most patients die during the process of evaluation.
Consequences of ICD Deactivation
A different care provider mostly a cardiologist often carries out the deactivation of the device. As a result, the continuity of care stops because the previous care provider would not know how to handle the patient without the device. Additionally, it is hard for practitioners to determine a person’s life expectancy with certainty. Therefore, too early deactivation can lead to early or premature deaths (Mabry, 2013). However, having clear guidelines on how to operate the ICD device can help reduce time delays during the deactivation process and prevent painful shocks at the time of death. Interdisciplinary operations during the deactivation process can improve the continuity of care and ensure that patients do not suffer depression after the ICD deactivation.
Clinical Implications
The information provided in this article is quite relevant to the clinical operation of the today’s health industry. Heart conditions are on the rise, and there is a need to equip care providers to handle such matters. The article presents critical information that can help clinicians develop effective ways of handling ICD’s and patients suffering from heart conditions. The major cause of deactivation delays is the practitioners’ lack of relevant knowledge. The information presented in the systemic review helps fill the information gaps, thus enabling healthcare providers to handle ICD’s effectively. Nurses are the first people to realize any changes in the health conditions of patients. For this reason, having adequate information concerning ICD and the deactivation process will enable nurses to provide patients with better patient-centered care. Informed health care providers translate to informed patients. The nurses can initiate programs to educate patients and their family members on the importance of ICD deactivation at the time of death (Russo, 2011). The willingness of the patient to initiate the deactivation process will ease the burden of device deactivation on practitioners. Additionally, informed healthcare providers will help reduce the unnecessary delays experienced as practitioners seek redundant psychiatric and ethics consultations.
The lack of formal protocol in the device deactivation has contributed to the issues surrounding the deactivation process. The information provided in the systemic review provides ideal guidelines for clinicians to develop guidelines for conducting the deactivation process. The paper offers certain suggestions that both the healthcare provider and the patient should partake to enhance the deactivation process. For instance, patients must be willing to sign a non-resuscitation agreement in case they request the device deactivation. To ease the tension in the last days, the nurses can initiate a program to equip patients with critical information concerning the device deactivation at the time of implantation. Incorporating device deactivation in the plan of care prepares both the patient and the care provider psychologically for the deactivation process (Mabry, 2013). On the other hand, the information provided in the systemic review provides an ideal opportunity for nurses to enhance coordination with cardiologists. One of the complications of device deactivation is a discontinuity of care. The gap between primary care providers and the cardiologists can be sealed by having the two professionals work together for the good of the industry.
References
Mabry, R. (2013). Heart failure. Nashville, Tennessee: Thomas Nelson.
Russo, J. (2011). Deactivation of ICDs at the end of life: a systematic review of clinical practices and provider and patient attitudes. AJN, 111 (10), 26-36.