Family presence and surveillance during weaning from prolonged mechanical ventilation

Happ, Mary Beth; Swigart, Valerie; Tate, Judith A.; Arnold, Robert M.; Sereika, Susan M.; Hoffman, Leslie A.

doi:10.1016/j.hrtlng.2006.07.002

Cited by 58 publications

(60 citation statements)

References 38 publications

(33 reference statements)

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“…It was crucial for going ''backstage'' that they dared to trust the staff. This is in accordance with Burr, 1996Burr, , 1998Happ et al, 2007;Hupcey, 1999;Molter, 1979. One strategy used to create this interplay is the unit's adoption of a family-centred philosophy of care (Davidson et al, 2007;Mitchell and Chaboyer, 2010;Mitchell et al, 2009;Mitchell, 2008), including the following core concepts: dignity and respect, information sharing, participation and collaboration.…”

Section: Discussionsupporting

confidence: 90%

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Eriksson

Bergbom

Lindahl

2011

Intensive and Critical Care Nursing

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SummaryAim: The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method: The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings: Patients' narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives' narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion: The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there -a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.

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Section: Discussionsupporting

confidence: 90%

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Eriksson

Bergbom

Lindahl

2011

Intensive and Critical Care Nursing

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“…Most reviews of weaning from mechanical ventilation have examined only quantitative data [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Range of health care professionals [25][26][27][28][29][30][31][32][33][34][35] Patients only [36][37][38][39][40][41][42][43][44][45] Physicians only (intensivists or anesthetists working in intensive care units) [46][47][48][49] Patients' family members 50,51 Patients and nurses Participant interviews and observation 12,13,27,28,[31][32][33]40<...>…”

Section: Discussionmentioning

confidence: 99%

Weaning From Mechanical Ventilation: A Scoping Review of Qualitative Studies

Rose

Dainty

Jordan

et al. 2014

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. List 3 key factors that influence ventilator weaning. 2. Define a scoping review. 3. Describe the steps in conducting a scoping review.To read this article and take the CNE test online, visit www.ajcconline.org and click "CNE Articles in This Issue." No CNE test fee for AACN members.By Louise Rose, PhD, Katie N. Dainty, PhD, Joanne Jordan, PhD, and Bronagh Blackwood, PhDBackground Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors.Objective To identify factors that may influence weaning and adoption of weaning strategies and tools, clinicians' perceptions of weaning strategies, and weaning experiences of patients and patients' families. Method A scoping review of indexed and nonindexed publications was done. Qualitative studies of health care providers, patients, and patients' families involved in weaning were included. Two investigators independently screened 8350 publications and extracted data from 43 studies. Study themes were content analyzed to identify common categories and themes within the categories. Results The study sample consisted of nurses in 15 studies, nurses and patients in 1 study, various health care providers in 11, patients in 10, and physicians in 4. Categories identified were as follows: for nurses, role or scope of practice, informing decision making, and influence on weaning outcome; for health care providers, factors influencing weaning decisions or use of protocols, role or scope of practice related to weaning, and organizational structure or practice environment; for patients, experience of mechanical ventilation and weaning, experience of the intensive care environment, psychological phenomena, and enabling success in weaning; and for physicians, tools or factors to facilitate weaning decisions and perceptions of nurses' role and scope of practice. However, even for these easy-to-wean patients, organizational and clinician factors such as staffing levels, skill mix, experience, and decision-making hierarchy influence the weaning process and can delay weaning and extubation. Such delays may result in prolonged duration of mechanical ventilation and stay in the intensive care unit (ICU) and increased costs.3 Approximately 30% of patients treated with mechanical ventilation experience difficult or prolonged weaning. 4 For these patients, similar organizational and clinician factors influence the duration and success of weaning. Because of the risk of further prolongation of mechanical ventilation, reintubation, and increased mortality, 5,6 identification of potentially modifiable factors that cause delays in weaning, unsuccessful weaning trials, and unsuccessful attempts in extubation is needed.An important step in ascertaining patient, clinician, and organizational factors that influence weaning is obtaining the views and perceptions of clinicians, patients, and patients' families who experience the process. Using...

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“…The articles on end-of-life care and on patients' families in the ICU are closely intertwined, with the exception of 1 study 40 in which the researchers focused on the presence of patients' families as the patients were weaned from mechanical ventilation. In this study, patients' family members were observed not just touching and talking to patients but also providing interpretive and protective surveillance for them.…”

Section: Families and End-of-life Carementioning

confidence: 99%

Delivering Interprofessional Care in Intensive Care: A Scoping Review of Ethnographic Studies

Paradis¹,

Leslie²,

Puntillo³

et al. 2014

American Journal of Critical Care

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BackgroundThe sustained clinical and policy interest in the United States and worldwide in quality and safety activities initiated by the release of To Err Is Human has resulted in some high-profile successes and much disappointment. Despite the energy and good intentions poured into developing new protocols and redesigning technical systems, successes have been few and far between, leading some to argue that more attention should be given to the context of care. Objective To examine the insights provided by qualitative studies of interprofessional care delivery in intensive care. Methods A total of 532 article abstracts were reviewed. Of these, 24 met the inclusion criteria. Results Articles focused on the nurse-physician relationship, patient safety, patients' families and end-of-life care, and learning and cognition. The findings indicated the complexities and nuances of interprofessional life in intensive care and also that much needs to be learned about team processes. Conclusion The fundamental insight that interprofessional interactions in intensive care do not happen in a historical, social, and technological vacuum must be brought to bear on future research in intensive care if patient safety and quality of care are to be improved.

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Family presence and surveillance during weaning from prolonged mechanical ventilation

Cited by 58 publications

References 38 publications

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

The experiences of patients and their families of visiting whilst in an intensive care unit – A hermeneutic interview study

Weaning From Mechanical Ventilation: A Scoping Review of Qualitative Studies

Delivering Interprofessional Care in Intensive Care: A Scoping Review of Ethnographic Studies

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