Ventilatory weaning: a case study of protracted weaning

Pattison, Natalie; Watson, Jennifer

doi:10.1111/j.1478-5153.2008.00322.x

Cited by 11 publications

(14 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For ISV diagnosis, the characteristics dyspnea, increased agitation, decreased cooperation, increased heart rate and accessory muscle use, justified the inference of diagnosis, similar to our findings (19) . With regard to the relationship of the related factors to nursing diagnoses, a study found that bronchial secretions and retained secretions influenced by approximately 11 times the occurrence of IBP, and about three times IGE (16) .…”

Section: Discussionsupporting

confidence: 89%

Diagnósticos de enfermagem respiratórios para crianças com infecção respiratória aguda

et al. 2012

View full text Add to dashboard Cite

Objectives: To identify the prevalence of nursing diagnoses: ineffective breathing pattern (IBP) (00032), ineffective airway clearance (IAC) (00031), impaired gas exchange (IGE) (00030) and impaired spontaneous ventilation (ISP) (00033), their defining characteristics and related factors, in children with acute respiratory infection. Methods: A quantitative, transversal approach with 151 children. Data were collected by means of interviews and pulmonary evaluation. For data analysis, we used descriptive and inferential statistics. Results: The most prevalent diagnosis was IBP. Adventitious breath sounds and ineffective cough were the most prevalent defining characteristics. Adventitious breath sounds increased by 80% the chance for IAC. Among the related factors, the highlights were: secretions in the bronchi and retained secretions. Secretions in the bronchi favored in 80% the occurrence of IBP and in 60% of IAC. This verified a statistically significant association between the defining characteristics and related factors of the diagnoses studied. Conclusion: The four diagnoses were identified in children with acute respiratory infections, with different prevalences. Keywords: Respiratory tract infections/diagnosis; Child; Nursing diagnosis RESUMO Objetivos: Identificar a prevalência dos diagnósticos de enfermagem: Padrão respiratório ineficaz (PRI), Desobstrução ineficaz de vias aéreas (DIVA), Troca de gases prejudicada (TGP) e Ventilação espontânea prejudicada (VEP) suas características definidoras e fatores relacionados, em crianças com infecção respiratória aguda. Métodos: Estudo de abordagem quantitativa, transversal, com 151 crianças. Os dados foram coletados por meio de entrevista e de avaliação pulmonar. Para análise dos dados, foi utilizada a estatística descritiva e inferencial. Resultados: O diagnóstico mais prevalente foi PRI. Ruídos adventícios respiratórios e tosse ineficaz foram às características definidoras mais prevalentes. Ruídos adventícios respiratórios aumentam em 80% a chance para DIVA. Entre os fatores relacionados, destacaram-se: secreções nos brônquios e secreções retidas. Secreções nos brônquios favorecem em 80% a ocorrência de PRI e em 60% de DIVA. Verificou-se associação estatisticamente significante entre as características e fatores relacionados com os diagnósticos estudados. Conclusão: Os quatro diagnósticos foram identificados em crianças com infecções respiratórias agudas, apresentando prevalências distintas. Descritores: Infecções respiratórias/diagnóstico; Criança; Diagnóstico de enfermagem RESUMEN Objetivos: Identificar la prevalencia de los diagnósticos de enfermería: Patrón respiratorio ineficaz (PRI), Desobstrucción ineficaz de vías aéreas (DIVA), Intercambio de gases perjudicada (IGP) y Ventilación espontánea perjudicada (VEP) sus características definidoras y factores relacionados, en niños con infección respiratoria aguda. Métodos: Estudio de abordaje cuantitativo, transversal, realizado con 151 niños. Los datos fueron recolectados por medio de entrevista y de ...

show abstract

Section: Discussionsupporting

confidence: 89%

Diagnósticos de enfermagem respiratórios para crianças com infecção respiratória aguda

et al. 2012

View full text Add to dashboard Cite

show abstract

“…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<...>…”

Section: Discussionmentioning

confidence: 99%

“…Thematic content analysis Grounded theory [17][18][19]21,34,39,41 Case study 26,42 Unclear 33 15 (35) 11 (26) 10 (23) 4 (9) 2 (5) 1 (2) 10 (23) 10 (23) 9 (21) 7 (16) 3 (7) 4 (9) 25 (58) 8 (19) 6 (14) 3 (7) 1 (2) 15 (35) 10 (23) for decision making or use of weaning protocols and guidelines. This characteristic made interpretive synthesis difficult, and thus we opted to generate a narrative summary to comprehensively map knowledge provided by the included studies.…”

Section: Methodsmentioning

confidence: 99%

Weaning From Mechanical Ventilation: A Scoping Review of Qualitative Studies

Rose

Dainty

Jordan

et al. 2014

American Journal of Critical Care

View full text Add to dashboard Cite

A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. List 3 key factors that influence ventilator weaning. 2. Define a scoping review. 3. Describe the steps in conducting a scoping review.To read this article and take the CNE test online, visit www.ajcconline.org and click "CNE Articles in This Issue." No CNE test fee for AACN members.By Louise Rose, PhD, Katie N. Dainty, PhD, Joanne Jordan, PhD, and Bronagh Blackwood, PhDBackground Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors.Objective To identify factors that may influence weaning and adoption of weaning strategies and tools, clinicians' perceptions of weaning strategies, and weaning experiences of patients and patients' families. Method A scoping review of indexed and nonindexed publications was done. Qualitative studies of health care providers, patients, and patients' families involved in weaning were included. Two investigators independently screened 8350 publications and extracted data from 43 studies. Study themes were content analyzed to identify common categories and themes within the categories. Results The study sample consisted of nurses in 15 studies, nurses and patients in 1 study, various health care providers in 11, patients in 10, and physicians in 4. Categories identified were as follows: for nurses, role or scope of practice, informing decision making, and influence on weaning outcome; for health care providers, factors influencing weaning decisions or use of protocols, role or scope of practice related to weaning, and organizational structure or practice environment; for patients, experience of mechanical ventilation and weaning, experience of the intensive care environment, psychological phenomena, and enabling success in weaning; and for physicians, tools or factors to facilitate weaning decisions and perceptions of nurses' role and scope of practice. However, even for these easy-to-wean patients, organizational and clinician factors such as staffing levels, skill mix, experience, and decision-making hierarchy influence the weaning process and can delay weaning and extubation. Such delays may result in prolonged duration of mechanical ventilation and stay in the intensive care unit (ICU) and increased costs.3 Approximately 30% of patients treated with mechanical ventilation experience difficult or prolonged weaning. 4 For these patients, similar organizational and clinician factors influence the duration and success of weaning. Because of the risk of further prolongation of mechanical ventilation, reintubation, and increased mortality, 5,6 identification of potentially modifiable factors that cause delays in weaning, unsuccessful weaning trials, and unsuccessful attempts in extubation is needed.An important step in ascertaining patient, clinician, and organizational factors that influence weaning is obtaining the views and perceptions of clinicians, patients, and patients' families who experience the process. Using...

show abstract

“…In the first year of the journal, clinician‐authored papers tended to focus on matters such as: providing counselling in intensive care unit (ICU) (Mellish 1996), using intracranial pressure (ICP) monitoring (Odell 1996) and changing practice to primary nursing (Bray 1996). In 2009, clinicians are writing highly complex and conceptual papers, for example the reflective analysis of using nursing diagnoses to manage problems related to weaning (Pattison and Watson 2009) and the systematic review of anticoagulant therapy in critically ill patients undergoing continuous renal replacement therapy (Tillman 2009). The development of free online resources for academic writing is helpful for clinicians, students and supervisors, for example the Online Writing Lab (OWL) at Purdue, see http://owl.english.purdue.edu/owl/ (accessed 13/10/09), which also has useful sections for those who have English as a second (or additional) language.…”

Section: Authorshipmentioning

confidence: 99%