Abstract:
BACKGROUND:Nurse-led (protocol-directed) ventilation weaning (NLVW) is utilized in adult intensive care and has shown to be safe and reduce ventilation times. Our paediatric intensive care unit (PICU) implemented a NLVW (and extubation) protocol in 2004, yet it was observed that some NLVW-trained nurses were not undertaking the role in practice. AIMS:To explore PICU nurses' and doctors' perceptions of and barriers to NLVW on a UK PICU, with the aim of facilitating more NLVW on our PICU by reducing these barriers. METHODS:A cross-sectional electronic survey was used to collect data from both nurse ventilation weaners and all medical staff and advanced nurse practitioners (ANPs) on one PICU. RESULTS:Our survey response rates were 90% (36/40) nursing and 54% (20/37) medical. The four top reasons cited for nurses not being able to wean by protocol were not being allocated to a 'weanable' patient, being in an in-charge or runner role, high clinical workload and a perceived lack of support from medical staff/ANPs. The restrictive nature of our protocol also emerged as a key issue by all staff. The medical survey revealed an overwhelming positive response to NLVW with 90% believing that experienced PICU nurses should be allowed to wean ventilation. In contrast to the nurses perceived lack of support or encouragement for NLVW, medical staff rated their encouragement for the nurses to undertake this role as high. CONCLUSIONS:NLVW is a complex process, and factors that impair or facilitate this process relate not only to the weaning protocol itself, but also organizational processes and structural factors in a PICU. RELEVANCE TO CLINICAL PRACTICE:This paper highlights the complexities involved in instituting and establishing a nurse-led, protocol-driven ventilation weaning process within a PICU. Further, in depth research is required to examine both PICU nurses and doctors attitudes to NLVW both in the UK and across Europe.
journal_name
Nurs Crit Carejournal_title
Nursing in critical careauthors
Tume LN,Scally A,Carter Bdoi
10.1111/nicc.12055subject
Has Abstractpub_date
2014-11-01 00:00:00pages
292-303issue
6eissn
1362-1017issn
1478-5153journal_volume
19pub_type
杂志文章abstract::This review examines, by means of a literature search, the needs of parents who have a critically ill child on adult intensive therapy units. These needs are compared with the needs of relatives of adult patients in ITUs. Whether nurses trained in adult nursing have the necessary skills, knowledge and attitudes to car...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1997-05-01 00:00:00
abstract::The transfer of information between nurses from emergency departments (EDs) and critical care units is essential to achieve a continuity of effective, individualized and safe patient care. There has been much written in the nursing literature pertaining to the function and process of patient handover in general nursin...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1478-5153.2007.00244.x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Brain death is the total loss of all brain and brain stem functions, and its diagnosis is often confirmed by an apnoea test, which relies on disconnecting the patient from the ventilator. Auto-triggering or auto-cycling is defined as a ventilator being triggered in the absence of patient effort, intrinsic re...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12029
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:To avoid the possible complications of prolonged intubation, it is necessary and advisable to attempt weaning from the tracheostomy tube at the earliest opportunity. However, while weaning protocols have proven successful in reducing ventilation time of critical care patients, there is little evidence of the...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2008.00325.x
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12348
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The assessment of sleep quality in critically ill patients is a relevant factor of high-quality care. Despite the fact that sleep disturbances and insufficient sleep management contain an increased risk of severe morbidity for these patients, a translated and applicable instrument to evaluate sleep is not av...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/nicc.12275
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:A primary focus of hospital treatment following admission for subarachnoid haemorrhage (SAH) is a prevention of cerebral artery vasospasm, which may result in ischaemic stroke. Intraventricular catheter (IVC) insertion to facilitate cerebral spinal fluid (CSF) drainage and intracranial pressure (ICP) monitor...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2010.00444.x
更新日期:2011-09-01 00:00:00
abstract::Numbers of patients undergoing coronary angiography and angioplasty procedures have increased in England due to targets within the National Service Framework for Coronary Heart Disease. Little evidence is available regarding optimal bed-rest duration for patients post-femoral arterial sheath removal following these pr...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1362-1017.2005.00121.x
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:Delirium in the intensive care unit (ICU) is associated with increased mortality, longer hospital stays, and increased odds of institutionalization after discharge. Delirium is a significant complication that occurs frequently in ICU yet lacks a standardized treatment protocol. Because of the limited effec...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12594
更新日期:2021-01-20 00:00:00
abstract:AIMS AND OBJECTIVES:To determine the effectiveness of an oral health care program for preventing ventilator-associated pneumonia (VAP). BACKGROUND:Research has shown a significant correlation between oral bacteria and VAP, indicating that an oral health care program plays a very important role in VAP prevention. DESI...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12037
更新日期:2015-03-01 00:00:00
abstract::It has been recommended that nursing staff who are new to paediatric intensive care should be offered an orientation programme There is no guidance currently available to influence the content or duration of such a programme on a national level A multi-centre research study was carried out to identify the existing pro...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract::The aim of this small-scale study was to measure, analyse and compare levels of acoustic noise, in a nine-bedded general intensive care unit (ICU). Measurements were undertaken using the Norsonic 116 sound level meter recording noise levels in the internationally agreed 'A' weighted scale. Noise level data were obtain...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2007.00229.x
更新日期:2007-07-01 00:00:00
abstract::A brief summary of the reasons why a pregnant woman may require intensive care is outlined. The clinical relevance of the physiological changes occurring in pregnancy is discussed. The haemodynamic differences and their relevance to monitoring are highlighted. ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract::Quality of life is a dynamic, multi-dimensional concept, the essence of which is its individuality. In this study quality of life six to 12 months after intensive care was not significantly lower than quality of life prior to intensive care, assessed retrospectively. Family, leisure activities and people were seen as ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::The purpose of this study was to investigate the needs of relatives of patients on a cardiothoracic ICU, as perceived by themselves. An exploratory research design was used--a modified replication of a study carried out by Molter (1979) in the USA. Data were collected from a sample of convenience consisting of 14 rela...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Because of the COVID-19 pandemic, health care systems worldwide are working under challenging conditions. Patients, who are seriously ill, require intensive care admission. In fighting COVID-19, nurses are frontline health care workers and, as such, have a great responsibility providing needed specialized pa...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12589
更新日期:2021-01-05 00:00:00
abstract:AIM:The aim of this paper is to reflect upon the management interventions of non-invasive ventilation (NIV) and diuretic therapy that were implemented for a patient admitted to an intensive care unit (ICU) with acute cardiogenic pulmonary oedema. BACKGROUND:Acute pulmonary oedema is a serious and life-threatening comp...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2011.00410.x
更新日期:2011-07-01 00:00:00
abstract::The nature of informed consent is bound within legal and moral duties. An analysis of informed consent includes the elements of understanding, disclosure, competence, voluntariness and authorisation, all of which can be affected by a variety of factors. Nurses can make a unique contribution to informed consent situati...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract:AIMS AND OBJECTIVES:This paper aims to undertake a review on the current evidence available on therapeutic hypothermia (TH) following cardiac arrest. BACKGROUND:The use of TH has been associated as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. Within th...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2008.00267.x
更新日期:2008-05-01 00:00:00
abstract:AIM:This article is a literature view of student nurses' experiences of critical care and the value of their experience to the nursing community. To explore the literature in relation to the value of critical care as a learning environment, the experiences and perceptions of student nurses in critical care and the impa...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/nicc.12053
更新日期:2014-11-01 00:00:00
abstract:AIM:To explore the meaning of vigilant attendance for relatives of critically ill patients in Greece. BACKGROUND:A plethora of international research has identified proximity to the patient to be a major concern for relatives of critically ill patients. Greece however follows a strict visiting policy in intensive care...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12054
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to establish a standardized approach to the initial care of patients with diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS). DKA and HHS are metabolic emergencies. Effective and efficient management is the responsibility of the multidisciplinary team. The ad...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:10.1111/j.1478-5153.2007.00259.x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have d...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/nicc.12273
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Diaries in the Intensive Care Unit (ICU) support patients and relatives during and after a stay on the ICU. Barriers to implementation of the ICU diary are workload, unwanted closeness to patients and lack of time. AIMS AND OBJECTIVES:The purpose of the study was to evaluate the time nurses consume writing ...
journal_title:Nursing in critical care
pub_type: 杂志文章,多中心研究
doi:10.1111/nicc.12046
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Patients admitted to the intensive care unit (ICU) will more often than not require sedative and analgesic drugs to enable them to tolerate the invasive procedures and therapies caused as a result of their underlying condition and/or necessary medical interventions. AIM:This article reports a study explorin...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2008.00282.x
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain n...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/nicc.12083
更新日期:2016-05-01 00:00:00
abstract::It was observed in practice that the withdrawal of extracorporeal membrane oxygenation (ECMO) was the cause of much ethical and moral discussion amongst nurses within the ITU where the study took place. No previous literature was located addressing the withdrawal of ECMO, from either a medical or nursing perspective. ...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:The intensive care unit (ICU) is not only a place to recover from injuries incurred during accidents and from serious illness. For many patients, it is also a place where they might die. Nursing care does not stop when a patient dies; rather, it continues with the care of the deceased and with family support...
journal_title:Nursing in critical care
pub_type: 杂志文章
doi:10.1111/j.1478-5153.2012.00525.x
更新日期:2012-11-01 00:00:00
abstract::The nature of the supervising relationship is explored in relation to an intensive care unit. The relationship between clinical supervision and individual performance review is discussed. Preparation and support for the supervisor's role is identified. Peer, group and external supervision arrangements are explored. ...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::Factors influential in the occurrence and timing of heart attacks are summarised. Patients' and partners' experiences of heart attack are reviewed. Evidence is presented for the efficacy and effectiveness of cardiac rehabilitation programmes. A three elemental model for cardiac rehabilitation is introduced. Key recomm...
journal_title:Nursing in critical care
pub_type: 杂志文章,评审
doi:
更新日期:1996-09-01 00:00:00