Nurses' perception of their role in extracorporeal membrane oxygenation care: A qualitative assessment

Abstract

Background: Recently, there has been interest in the education of nursing personnel to provide veno-venous extracorporeal membrane oxygenation in Kuwait. There is need to understand the experience of nurses who take on this new role. Aim:We aimed to explore the perspectives of nurses about their role, with a special focus on their competencies and the challenges faced while caring for patients who require extracorporeal membrane oxygenation.Methods: We used a qualitative descriptive approach, using in-depth individual interviews. Nineteen nurses working with veno-venous an extracorporeal membrane oxygenation machine in an adult intensive care unit of a general hospital in Kuwait were included in the study. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.Results: The role of nurses was found to be diverse and challenging and involved engaging in multiple responsibilities. Nurses worked with other health care providers in a team, which facilitated their performance. Nurses viewed themselves as competent to perform their role and attributed their competency mainly to the training received and the experience spent providing extracorporeal membrane oxygenation care. In executing their role, nurses reported encountering significant challenges, including heavy workload, inefficient communication among colleagues, and a lack of an organized/supportive system.Conclusions: This study suggests that nurses play an integral role in the management of patients on extracorporeal membrane oxygenation. An understanding of their role and their competence, the challenges they face with in the care setting, and providing a supportive environment is essential for transformation in the practice of extracorporeal membrane oxygenation nursing.

Extracorporeal Membrane Oxygenation for Adults and Children With Severe Respiratory Failure

“…Three studies used a descriptive qualitative design, [8][9][10] and 2 studies did not report the type of study design used. 11,12 One study each used the following: focused ethnography, 13 grounded theory, 14 and interpretive phenomonology.…”

“…16 Six studies collected data using semi-structured or in-depth interviews. [8][9][10]12,14,16 One study collected data using observations and interviews, 13 and another used interviews and documents. 11 One study collected data using focus groups.…”

“…15 Four studies analyzed their data using thematic analysis. [8][9][10]15 One study each used the following: descriptive abductive, 13 content analysis, 11 qualitative descriptive, 16 Miles and Huberman's 3-phased analysis, 12 and grounded theory. 14…”

“…Three studies included health care providers who care for adult patients using ECMO. 8,11,15 Three studies included adult participants who had themselves received ECMO. 9,12,16 Two studies included family members who had supported an adult who had received ECMO.…”

“…[9][10][11]13 Two studies did not specify which type of ECMO was involved, 12,16 whereas 2 studies focused on VV only. 8,14 One study included both ECMO (not specified) and ventricular assist devices. 15…”