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 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 A Systematic Review of Pain Assessment in Mechanically Ventilated Patients

2021 ◽  
Vol 14 (1) ◽  
pp. 22-31
Author(s):  
Elaheh Salamat ◽  
Farshad Sharifi ◽  
Mohammad Amin Valizade Hasanloei ◽  
Fatemeh Bahramnezhad
Keyword(s):  
Systematic Review ◽  
Pain Assessment ◽  
Self Report ◽  
Detection Accuracy ◽  
Validity And Reliability ◽  
Exclusion Criteria ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Published Evidence ◽  
Ventilated Patients

Introduction: Pain self-report is the gold standard of pain assessment. Mechanically ventilated patients cannot self-report the pain due to the presence of a tracheal tube and changes in the level of consciousness caused by sedation, exposing them to the risk of inadequate pain management that leads to psychological and physiological consequences. This study aimed to present a review of the published evidence and studies concerning the scales used in pain assessment in mechanically ventilated patients according to their psychometric characteristics and application in the nursing practice. Methods: We conducted a systematic review following PRISMA guidelines. National and international journals in such databases as Science Direct, PubMed, EMBASE, Pro Quest Central, Web of Science, SID, and Magiran were searched using Persian and English keywords, and retrieved articles were included in this review based on the inclusion and exclusion criteria. Results: 22 articles were included in this review based on the inclusion and exclusion criteria. According to the research objectives, findings were extracted from selected articles and reviewed in two sections: 1] validity and reliability, and 2] clinical application. Conclusion: Scales of CPOT and BPS are superior to NVPS, and a combination of BPS and CPOT improves the pain detection accuracy, and vital symptoms should be used cautiously for pain assessment along with objective measures due to poor evidence. Moreover, rapid and effective pain relief plays an important role in the improvement of psychological and physiological consequences.

Sign in / Sign up

Export Citation Format

Share Document