Successful Mechanical Ventilation Weaning Experiences at Respiratory Care Centers

Abstract

A phenomenological qualitative study was conducted on the experiences of patients who had been successfully weaned from mechanical ventilation, including essential elements of the patient support system during the weaning process. In-depth interviews were conducted with 20 participants who had been recruited through purposive sampling from three respiratory care centers in Taiwan. The experiences of participants who had been successfully weaned from mechanical ventilation could be categorized into five themes, which were (a) dealing with the unfamiliar context presented by the weaning program, (b) experiencing various psychological responses and self-endurance ambiguity, (c) being tortured by helplessness, (d) wondering whether to continue or give up, (e) and release from self-breathing. Findings were intended to give nurses an increased understanding of patient experiences and help in raising their competence in managing patient emotional reactions that arise during the weaning process. As patient conditions gradually improve, nurses should assess the criteria for mechanical ventilation weaning and provide preparatory information and clarify patient questions to avoid potential negative responses during the process. Participants also reported that the professionalism of nurses and concern from family members were essential sources of support for successful weaning. Nurses can apply recommendations to develop effective patient support systems that encourage family members to accompany patients at critical times during the weaning process. Therefore, the results of this study may assist healthcare personnel to develop strategies to ensure successful weaning from mechanical ventilation.

The Impact of Different Nursing Skill Mix Models on Patient Outcomes in a Respiratory Care Center

“…Moreover, fewer patients who received All‐RN care failed to be weaned from the ventilator compared to the patients who received RN/Aide care. As noted in previous qualitative studies, the concern of nurses and close family members for patients is an important factor in the process of being weaned from the ventilator (Chen et al 2009). Our findings support the notion that conscious patients need more psychological support, and that an increase in professional nursing staff to guide the weaning process could effectively reduce patients’ fear and stress.…”

The impact of three nursing staffing models on nursing outcomes

“…This finding is congruent that of Yang et al (2012), whose comparison of the effects of two different nursing skill mix models revealed that the patients in the group with 60-70% RNs had lower ventilator weaning rates than the patients in the 100% RN group. Therefore, care from RNs and family is an important factor for successful ventilator weaning (Chen et al 2009). Therefore, care from RNs and family is an important factor for successful ventilator weaning (Chen et al 2009).…”

“…Previous studies have observed that patients experienced impaired communication, deficit of interaction, restlessness, loneliness and loss of control during mechanical ventilator weaning (Schou & Egerod 2008). Therefore, care from RNs and family is an important factor for successful ventilator weaning (Chen et al 2009). During mechanical ventilator weaning, RNs should regularly perform correct and professional evaluations and regularly observe whether patients are experiencing inadequate respiratory muscle endurance, as evidenced by dyspnoea, hyperventilation and inadequate blood oxygen supply.…”

Weaning From Mechanical Ventilation: A Scoping Review of Qualitative Studies

“…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<...>…”