Outcomes of Implementing the Nurse-Led Respiratory Care Intervention for Mechanically Ventilated Patients

Document Type : Research articles

Authors

1 Assistant lecturer, Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

2 Professor Emeritus, Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

3 Professor , Critical care medicine, Faculty of medicine, Alexandria University

4 Assistant Professor Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Abstract

Background: Critically ill patients receiving mechanical ventilation have a high
hospital mortality rate, which is related to nosocomial infection and unsuccessful
weaning. The critical care nurse plays an essential role in minimizing these
pulmonary complications through the application of different respiratory care
interventions. Objective: To determine the outcomes of implementing the nurse-led
respiratory care intervention for mechanically ventilated patients. Settings: The
study was carried out in three adult ICUs at Alexandria Main University Hospital.
Subjects: A convenience sample of 80 critically ill patients, which was divided
randomly into two equal groups (40 patients in each). The intervention group was
assigned to the nurse-led respiratory care intervention that included electrical
diaphragmatic muscle stimulation, chest physiotherapy maneuvers, and patient
mobilization, and the control group was subjected to hospital routine care. Tools:
Three tools were used. Tool one: "Patient's profile data tool". Tool two: “The
ventilator-associated events calculator". Tool three: "Modified Burns Wean
Assessment Program (m-BWAP) Scores". Results: The study results showed that the
occurrence of ventilator-associated events was significantly reduced in the
intervention group compared to the control group (χ²=6.348, pMC=0.022).
Furthermore, the spontaneous breathing trial over five days showed a statistically
significant difference (P=0.03) between the two groups. Conclusion: Implementation
of the nurse-led respiratory care intervention significantly reduced the occurrence of
ventilator-associated events and increased the success rate of spontaneous breathing
trials. Recommendations: Critical care nurses should integrate the nurse-led
respiratory care intervention into their daily practice of mechanically ventilated
patient.

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