Prevalence and Intensive Care Bed Use in Subjects on Prolonged Mechanical Ventilation in Swedish ICUs

Cederwall, Carl-Johan; Naredi, Silvana; Olausson, Sepideh; Rose, Louise; Ringdal, Mona

doi:10.4187/respcare.08117

Cited by 14 publications

(10 citation statements)

References 29 publications

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“…The management of critically ill patients takes on many levels ( 12 – 14 ). First, improving patients' outcomes with patient-centered care, proactive management, and vigilance, coping with unpredictable events, and providing emotional support ( 4 , 15 ). Second, continuous observation, so as to reduce a patient's risk of deterioration, monitor their total dependence on support equipment, and prevent their agitation or confusion that may lead to harm ( 16 ).…”

Section: Review Of Literaturementioning

confidence: 99%

“…On recovery, patients need to be weaned-off (withdrawal) the MV gradually and carefully ( 1 – 3 ). In fact, the weaning process should be conducted with caution and consistent to reduce the time and unexpected consequences to the patients ( 4 – 6 ). Also, this is to comply with the indications and prevent any complications from postcardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

“…The complexity of this process is dependent on the condition, complication, and need for MV among the patients ( 4 ). However, to maintain standards, prevent mismanagement, malpractice, unsafe treatment, any negligence, carelessness, inattentiveness, and ensure patient safety, a clinical practice guideline (CPG) is required for structured nursing training ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

Awang

Alias

DeWitt

et al. 2021

Front. Public Health

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Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.

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Section: Review Of Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

Awang

Alias

DeWitt

et al. 2021

Front. Public Health

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“…(1,643) required MV, and 0.8% (307) underwent prolonged MV (those with more than 21 days of device use). Longer ICU stays were associated with the use of MV, and the mortality of individuals using this device was 21% (CEDERWALL et al, 2021). Indicated in acute respiratory failure (ARF) or acute chronic respiratory failure, MV can partially or totally replace spontaneous ventilation.…”

Section: Introductionmentioning

confidence: 99%

Nurses' Knowledge Regarding The Management Of Invasive Mechanical Ventilation: Integrative Review

Novaes¹,

Mansano²,

Zulin³

et al. 2023

Collection of International Topics in Health Science- V1

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to identify in the literature the nurses' knowledge regarding the management of invasive mechanical ventilation. Metodologia: Trata-se de uma revisão integrativa que contemplou estudos publicados entre janeiro de 2017 a maio de 2022, disponíveis na integra eletronicamente, com enfoque em adultos, não restringindo o idioma, a localidade de origem das produções e o método utilizado. Thematic analysis was adopted and the data were operationalized by the Iramuteq® software. Results: nine studies were found that approached the theme. From the analysis three classes emerged, being: 1st Class: (Un)Knowledge about the care of patients under mechanical ventilation in Intensive Care Unit; 2nd Class: Educational strategies for the qualification of professionals who act in the care of patients under mechanical ventilation; and 3rd Class: Professional autonomy of nurses for the decision making in the care of patients under MV. Final considerations: a gap was identified in the formation and qualification of nurses to develop nursing care with quality, safety and autonomy. The nurse plays a relevant role in the management of patients on mechanical ventilation, acting in three pillars considered essential: care, management and education/research.

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“…En general, si la extubación se estima posible antes de los 10 días, no se recomienda realizar traqueostomía, porque los beneficios de su ejecución precoz son inciertos en términos de reducir la mortalidad, el tiempo en VMI o la estadía hospitalaria. Por otra parte, no se recomienda mantener el tubo endotraqueal cuando la ventilación se extiende o se estima que se puede extender por más de tres semanas, lo que ocurre en un 0.8 a 13% de los pacientes adultos ventilados (8,9). En población adulta aun no está claro cuando hacer la traqueostomía ni los beneficios que tendría realizarla precozmente, antes de los 7 a 10 días (10), aunque revisiones recientes mostrarían algunos beneficios de su indicación precoz, incluida una menor mortalidad.…”

Section: Introductionunclassified

Traqueostomía en Prematuros Con Displasia Broncopulmonar Grave

Recondo¹

2023

Neumol Pediatr

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Los recién nacidos con displasia broncopulmonar dependientes de ventilación mecánica a las 36 semanas, corresponden en general a prematuros menores de 27 semanas con morbilidad grave: enterocolitis, infecciones, retinopatía, retraso en el crecimiento y secuelas del neurodesarrollo. Si la extubación no es posible entre las 40 y 50 semanas, se indica una traqueostomía, normalmente acompañada de una gastrostomía. La decisión depende del apoyo ventilatorio, de la morbilidad asociada (neurológica, hipertensión pulmonar, lesiones de la vía aérea) y del grado de desnutrición. La traqueostomía optimiza el manejo ventilatorio, disminuye la necesidad de sedación, facilita la movilidad, la neurorrehabilitación y el alta al hogar en ventilación domiciliaria. La edad óptima de ejecución no está estandarizada, pero hay evidencia que muestra beneficios en el neurodesarrollo si se realiza antes de los 120 días de vida. La mayoría de los prematuros traqueostomizados son manejados en domicilio y a los 5 años ya se encuentran decanulados.

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Prevalence and Intensive Care Bed Use in Subjects on Prolonged Mechanical Ventilation in Swedish ICUs

Cited by 14 publications

References 29 publications

Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

Nurses' Knowledge Regarding The Management Of Invasive Mechanical Ventilation: Integrative Review

Traqueostomía en Prematuros Con Displasia Broncopulmonar Grave

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