Survey of cuff management practices within Australia and New Zealand intensive care units

2008 ◽  
Vol 21 (1) ◽  
pp. 62
2008 ◽  
Vol 17 (5) ◽  
pp. 428-435 ◽  
Author(s):  
Louise Rose ◽  
Leanne Redl

Background Cuff management varies widely in Europe and North America. Little is known about current practice in Australia and New Zealand. Objective To characterize important aspects of cuff management in intensive care units in Australia and New Zealand to compare with international reports. Methods A questionnaire was sent to all nurse managers of adult intensive care units in Australia and New Zealand. Results Survey response was 53% (92/175). After intubation, most units (50/92, 54%) used both minimal occlusive volume technique and cuff pressure measurement; 5 (5.5%) used these methods along with pilot balloon palpation. Twenty units (22%) used cuff pressure measurement exclusively and 16 units (17.5%) used the minimal occlusive volume technique exclusively. Only 1 unit (1%) used the minimal leak technique after intubation. For ongoing management, cuff pressure measurement was the preferred method, used exclusively in 42 units (46%), with the minimal occlusive volume technique used in 40 units (43%; sole method in 6 units [7%]) and palpation in 4 units (4%). In most units (65/92, 71%), cuffs were monitored once per nursing shift. In units using the minimal occlusive volume technique, oropharyngeal suctioning (74%) and semirecumbent positioning (58%) were routinely incorporated; sigh breaths (6%), discontinuation of enteral feeding (10%), and nasogastric tube aspiration (26%) were uncommon. Cuff management protocols (37%) and subglottic suctioning (12%) were used infrequently. Conclusions Cuff pressure measurement was the preferred method, used exclusively or in combination with other methods. The minimal occlusive volume technique was used more often after intubation than for ongoing management.


Author(s):  
Alexis Tabah ◽  
Mahesh Ramanan ◽  
Rachel L. Bailey ◽  
Shaila Chavan ◽  
Stuart Baker ◽  
...  

2010 ◽  
Vol 36 (8) ◽  
pp. 1410-1416 ◽  
Author(s):  
Lahn D. Straney ◽  
Archie Clements ◽  
Jan Alexander ◽  
Anthony Slater

2021 ◽  
Author(s):  
◽  
Diane Margaret Mackle

<p>This study explored the role of the research nurse in New Zealand (NZ) Level III intensive care units (ICU). Little was known about this role in NZ prior to this study. A qualitative, descriptive approach, using semi-structured interviews was used. The study was conducted in six Level III ICUs throughout NZ, who employed a research nurse. Interviews were conducted with research nurses (n = 11), the doctors they work with (principal investigators) (n = 6) and nurse managers (n = 6) for the ICUs, and the findings were triangulated. The views across all ICUs and stakeholders were generally similar, with differences only being in some operational areas. This study found that the primary role of the research nurse was trial management, where they coordinated all elements of trial conduct. Almost half of the research nurses were also involved in trial design through their positions on management committees. Research nurses also played a vital role in patient and trial advocacy, and they bridged the knowledge gap by bringing research to staff nurses, patients and their families. The issue of consent for clinical trials in the ICU setting was significant, as this was a process which research nurses were very involved in. Consenting patients was a shared responsibility of research nurses and doctors. There was a perception that research nurses were senior nurses, but not necessarily because of their role in research. The majority of research nurses reported to a nursing line manager, and also had an informal accountability to the principal investigator (PI). Research nurses and PIs worked closely in the pursuit of rigorous research for ICU patients, and research nurses were highly regarded by PIs. This study provides clarity about the research nurse‟s role and showcases their key contribution in ensuring that NZ ICUs undertake high quality research, thus contributing to potential improvements for future patients‟ outcomes.</p>


Author(s):  
Rachel L. Bailey ◽  
Mahesh Ramanan ◽  
Edward Litton ◽  
Nathalie Ssi Yan Kai ◽  
Fiona M. Coyer ◽  
...  

2011 ◽  
Vol 39 (5) ◽  
pp. 926-935 ◽  
Author(s):  
K. M. Hewson-Conroy ◽  
A. R. Burrell ◽  
D. Elliott ◽  
S. A. R. Webb ◽  
I. M. Seppelt ◽  
...  

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