title: A resuscitation "dilemma" theory-practice-ethics. Is there a theory-practice-ethics gap?
abstract: The theory-practice-ethics gap - a new paradigm to contemplate. Practices based on tradition, rituals and outdated information are placed into a nonscientific paradigm called the theory-practice gap. Within this paradigm there is often a gap between theoretical knowledge and its application in practice. This theory-practice gap has always existed [Allmark, P., 1995. A classical view of the theory-practice gap in nursing. J. Adv. Nurs. 22 (1), 18-23; Hewison, A. et al., 1996. The theory-practice gap in nursing: a new dimension. J. Adv. Nurs. 24 (4), 754-761]. Its creation is often sited as a culmination of theory being idealistic and impractical, even if practical and beneficial, are often ignored. Most of the evidence relating to the non integration of theory and practice makes the assumption that environmental factors are responsible and will affect learning and practice outcomes, hence the "gap". In fact, it is the author's belief, that to "bridge the gap" between theory and practice an additional component is required, called ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices are worthy and relevant to their role as healthcare providers. Otherwise, we fall victims to providing nothing more than a lip service. This introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in health care practice. The author believes that there is a crisis of ethics where theory and practice integrate, and as a consequence, malfeasance. We are failing to fulfill our duty as healthcare providers and as patient advocates. One practice of major concern, which the author will endeavor to unfold relates to adult and pediatric resuscitation.
authors: Cardiac Critical Care, King Abdulaziz Cardiac Centre, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors: Manfred
authors: M
authors: Mortell
keywords: CPR; Ethics; Exhaled air ventilation; External cardiac compression; Recommendations; Resuscitation; Theory–practice–caring gap
references: Circulation. 2004 Apr 27;109(16):1960-5
references: 15066941
references: Ann Surg. 1953 May;137(5):731-44
references: 13041122
references: Pediatr Clin North Am. 2008 Aug;55(4):1025-50, xii
references: 18675032
references: JAMA. 2006 Jan 4;295(1):50-7
references: 16391216
references: N Engl J Med. 2001 Apr 26;344(17):1304-13
references: 11320390
references: J Am Med Assoc. 1958 May 17;167(3):335-41
references: 13538712
references: Curr Opin Crit Care. 2006 Jun;12(3):207-12
references: 16672778
references: N Engl J Med. 2001 Aug 16;345(7):546; author reply 547
references: 11519518
references: Resuscitation. 2005 Nov-Dec;67(2-3):167-70
references: 16324984
references: Arch Intern Med. 2009 Jan 12;169(1):15-24
references: 19139319
references: JAMA. 2005 Jan 19;293(3):305-10
references: 15657323
references: Lancet. 1967 Aug 5;2(7510):271-3
references: 4165912
references: Curr Opin Crit Care. 2006 Jun;12(3):198-203
references: 16672776
references: N Engl J Med. 2004 Aug 12;351(7):647-56
references: 15306666
references: J Am Med Assoc. 1947 Dec 13;135(15):985
references: 20272528
references: N Engl J Med. 1956 Apr 19;254(16):727-32
references: 13309666
references: JAMA. 1960 Jul 9;173:1064-7
references: 14411374
references: J Adv Nurs. 1996 Oct;24(4):754-61
references: 8894893
references: Ann Emerg Med. 1990 Feb;19(2):179-86
references: 2301797
references: JAMA. 2005 Jan 19;293(3):299-304
references: 15657322
references: J Adv Nurs. 1995 Jul;22(1):18-23
references: 7560527