scholarly journals Nursing care and prevalence of adverse events in prone position: Characteristics of mechanically ventilated patients with severe SARS‐CoV‐2 pulmonary infection

2021 ◽  
Author(s):  
María Dolores Rodríguez‐Huerta ◽  
Ana Díez‐Fernández ◽  
María Jesús Rodríguez‐Alonso ◽  
María Robles‐González ◽  
María Martín‐Rodríguez ◽  
...  
Keyword(s):  
Adverse Events ◽  
Prone Position ◽  
Nursing Care ◽  
Pulmonary Infection ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Acute respiratory distress syndrome (ARDS)

2021 ◽  
pp. 137-144
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Nursing Care ◽  
Distress Syndrome ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Berlin Definition ◽  
General Management ◽  
Ventilated Patients

The incidence of describing acute respiratory distress syndrome (ARDS) is approximately 23% in mechanically ventilated patients. The diagnosis of ARDS varies widely; studies report a variation in the population diagnosed with ARDS, from 10 to 86 cases per 100,000. Complications of mechanical ventilation are common and include ventilator-associated pneumonia (VAP), barotrauma from excessive airway pressures, and volutrauma from excessive tidal volumes which may both worsen ARDS. Pneumothorax occurs in some patients, necessitating the placement of chest drains. This chapter starts with describing ARDS and the Berlin Definition, and its incidence. It also covers aetiology and physiology, then goes on to its treatment and general management. This includes respiratory support, position changes, and other treatments. Situation-dependent prognoses are outlined. Specific nursing care is also described.

scholarly journals Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review

2018 ◽  
Vol 23 (7) ◽  
pp. 614-630 ◽  
Author(s):  
Aziza Salem ◽  
Muayyad M Ahmad
Keyword(s):  
Endotracheal Tube ◽  
Nursing Care ◽  
Effective Communication ◽  
Patient Communication ◽  
Communication Strategy ◽  
Integrative Review ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Communication Barrier ◽  
Ventilated Patients

Background Communication with patients has always been a major concern in nursing care. Invasive mechanically ventilated (IMV) patients suffer from a communication barrier due to the presence of the endotracheal tube (ETT), which makes them unable to communicate through speech. Aim The purpose of this review is to examine available evidence regarding existing knowledge, skills, perceptions and barriers to IMV patient communication in order to guide the development of strategies that enhance effective communication with these patients. Methods A review of the published literature was conducted between January 2010 and December 2016. Results The literature support clear and concise communication in all areas of care, especially when patients suddenly become speechless. Invasive mechanically ventilated patients want to be heard, have control over their treatment and contribute to decisions concerning their health. Conclusion There is a need for the establishment of an effective nurse -patient communication strategy, which may include determining the mode of communication used by the patient, waiting and giving time to allow a patient to participate in the communication, confirming the message that was communicated with a patient himself/ herself, and the use of assistive and augmented communication to support comprehension when needed.

scholarly journals Lean thinking in total nursing care for mechanically ventilated patients: A new concept in ICU

2019 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Sally Mohammed Farghaly ◽  
Fatma Refaat Ahmed
Keyword(s):  
Nursing Care ◽  
Value Added ◽  
Self Report ◽  
Care Practice ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Total Care ◽  
Care Practices ◽  
The Cost ◽  
Ventilated Patients

Background: Lean approach is one of the coming revolutions for a better, improved, high-value-based care to maximize the benefit from nursing care activities. Additionally, it can shorten the mechanical ventilation duration and the total intensive care unit stay with a time and cost effective process. Lean is an improvement strategy based on the concept of eliminating the waste and creation of value-added care practices to the patients. Applying lean strategy for mechanically ventilated patients requires critical evaluation of all steps of the care to identify which add value and which do not.Methods: A descriptive research design was used in the current study and two tools were used for data collection in this study: “Lean assessment observational checklist of total care for mechanically ventilated patients”, and “Critical care nurses’ self-report about waste during total care of mechanically ventilated patients”.Results: The differences between value added and non-value added care practice items were not statistically significant in ventilator and patient care practices items (p = .232 and .884) respectively, while there was no statistical difference between the value added and non-value added care practice items in tube care. The differences between the time consumed in all care practices items were statistically significant (p < .001). According to the nurses' self-report, direct care for patients was ranked as the first care category that can increase the cost and effort followed by the indirect care category.Conclusions: Not all care items for mechanically ventilated patients have been added value to the patients. Waste outcomes as reported by nurses resulted in increase their efforts, time of care, in addition to increase the cost of care.

scholarly journals Improving patient safety during intrahospital transportation of mechanically ventilated patients with critical illness

2020 ◽  
Vol 9 (2) ◽  
pp. e000698 ◽  
Author(s):  
Shwu-Jen Lin ◽  
Chin-Yuan Tsan ◽  
Mao-Yuan Su ◽  
Chao-Ling Wu ◽  
Li-Chin Chen ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Critical Illness ◽  
Adverse Events ◽  
Vital Signs ◽  
Team Members ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Radiology Technicians ◽  
Ventilated Patients

AimIntrahospital transportation (IHT) of patients under mechanical ventilation (MV) significantly increases the risk of patient harm. A structured process performed by a well-prepared team with adequate communication among team members plays a vital role in enhancing patient safety during transportation.Design and implementationWe conducted this quality improvement programme at the intensive care units of a university-affiliated medical centre, focusing on the care of patients under MV who received IHT for CT or MRI examinations. With the interventions based on the analysis finding of the IHT process by healthcare failure mode and effects analysis, we developed and implemented strategies to improve this process, including standardisation of the transportation process, enhancing equipment maintenance and strengthening the teamwork among the transportation teammates. In a subsequent cycle, we developed and implemented a new process with the practice of reminder-assisted briefing. The reminders were printed on cards with mnemonics including ‘VITAL’ (Vital signs, Infusions, Tubes, Alarms and Leave) attached to the transportation monitors for the intensive care unit nurses, ‘STOP’ (Secretions, Tubes, Oxygen and Power) attached to the transportation ventilators for the respiratory therapists and ‘STOP’ (Speak-out, Tubes, Others and Position) attached to the examination equipment for the radiology technicians. We compared the incidence of adverse events and completeness and correctness of the tasks deemed to be essential for effective teamwork before and after implementing the programme.ResultsThe implementation of the programme significantly reduced the number and incidence of adverse events (1.08% vs 0.23%, p=0.01). Audits also showed improved teamwork during transportation as the team members showed increased completeness and correctness of the essential IHT tasks (80.8% vs 96.5%, p<0.001).ConclusionThe implementation of reminder-assisted briefings significantly enhanced patient safety and teamwork behaviours during the IHT of mechanically ventilated patients with critical illness.

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