scholarly journals Effectiveness of Teaching Program on Critical Care Nurses’ Performance during Endotracheal Suctioning in the Intensive Care Units in Syria

2021 ◽  
Vol 17 (34) ◽  
pp. 190
Author(s):  
Yaser Adnan Abo Jeesh ◽  
Elham Fath-Elalium Mohammed Khalid ◽  
Ishraqa Mohammed Ahmed Elbashier
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Data Collection ◽  
Life Support ◽  
Group Discussion ◽  
Critical Care Nurses ◽  
University Hospital ◽  
Initial Assessment ◽  
Teaching Program ◽  
Endotracheal Suctioning

Background: The Intensive Care Unit (ICU) is a unit in the hospital which provides intensive care for critically ill or injured patients and is staffed with specially trained medical personnel and has equipment that allows for continuous monitoring and life support. Moreover, critical care nurses (CCNs) should have strong analytical, interpersonal, and decision-making skills. Also they need to continuously improve their knowledge, skills, and safe practice to deliver safe and effective care to their patients. Objectives: This study aimed to assess the effect of the teaching program on CCNs performance during endotracheal suctioning. Design: The quasi-experimental design was used in this study. Methods: The study was conducted from June to September 2020. This study was conducted to assess the effect of the teaching program on nurse’s performance during endotracheal suctioning in the critical care units at Al-Assad University Hospital, Damascus. All available registered nurses (48 nurses) who were working in the previous ICUs during the period of data collection were included in this study. An observational checklist sheet was developed by the researcher after reviewing the related literature. The duration of data collection was about three months, and each nurse was observed once for each procedure during different shifts. Based on the nurses’ need according to their performance during the initial assessment, the researcher developed and designed the teaching program. This program continued for two weeks consisting of four phases and contains workshop-practices (8hours) per day and educational pamphlet handout. The workshop practice consists of lectures, group discussion, and training scenarios. Every nurse must attend the training sessions daily, at least one hour. Results: The results showed that the level of knowledge and practice of the studied nurses in endotracheal suction was average and poor before the teaching program and the nurse’s level improved after the program. There was a variation of improvement regarding the nurses age, qualification, and experience. The best performance was for nurses with age group between 20-24 years, nurses with a master degree, and nurses with less than five years of experience. Overall, this study found a statistically significant relationship before and after the implementation of the educational program (p<0.001). Conclusion: There has been an obvious improvement of nurses’ knowledge and performance after the teaching program in relation to age, qualifications, and experience in all selective procedures. It is essential to help the nurses to expand their knowledge and practices to provide a high quality of care and promote patient safety.

scholarly journals Evaluation of prevention of ventilator-associated infections in four Australian intensive care units

2020 ◽  
Vol 21 (4) ◽  
pp. 147-154
Author(s):  
Natasha Ciampoli ◽  
Stephane Bouchoucha ◽  
Judy Currey ◽  
Ana Hutchinson
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Care Delivery ◽  
Critical Care Nurses ◽  
Respiratory Care ◽  
Chart Audit ◽  
Endotracheal Suctioning ◽  
Standard Precautions ◽  
Mouth Care

Background: Effective approaches to practice improvement require development of tailored interventions in collaboration with knowledge users. Objectives: To explore critical care nurses’ knowledge and adherence to best practice guidelines for management of patients with an artificial airway to minimise development of ventilator-associated pneumonia. Methods: A cross-sectional study was undertaken across four intensive care units that involved three phases: (1) survey of critical care nurses regarding their current practice; (2) observation of respiratory care delivery; and (3) chart audit. Key care processes evaluated were: (1) technique and adherence to standard precautions when performing endotracheal suction, cuff pressure checks and extubation; and (2) frequency of endotracheal suctioning and mouth care. Results: Observational and chart audit data on the provision and documentation of respiratory care were collected for 36 nurse/patient dyads. Forty-six nurses were surveyed and the majority responded that endotracheal suctioning and mouth care should be performed ‘as required’ or every 2 hours (h). During observations of practice, no patient received mouth care every 2 h, nor had documentation of such. Inconsistent adherence to standard precautions and hand hygiene during respiratory care provision was observed. Chart audit indicated that nurses varied in the frequency of suctioning consistent with documented clinical assessment findings. Conclusion: Although nurses had good knowledge for the management of artificial airways, this was not consistently translated into practice. Gaps were identified in relation to respiratory related infection prevention, the prevention of micro-aspiration of oropharyngeal secretions and in the provision of mouth care.

scholarly journals The effect of scenario based teaching for critical care nurses and physicians on their knowledge of fluid creep

2018 ◽  
Vol 9 (4) ◽  
pp. 86
Author(s):  
Ghada Shalaby Khalaf Mahran ◽  
Asmaa Ali Mahgoub ◽  
Mostafa Samy Abass
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Fluid Resuscitation ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Critical Care Nurses ◽  
University Hospital ◽  
P Value ◽  
Nurses And Physicians

Introduction: Fluid resuscitation is a major component of the acute management of critically ill patients. The phenomenon of providing excessive fluid resuscitation volumes has been termed “fluid creep”. Today, the science of nursing becomes more complex. Accurate fluid balance assessment and recording is important component of nursing care that assures patient’s safety especially in critically ill patients. The aim of the work is to examine the effect of scenario based teaching for critical care nurses and physicians on their knowledge of fluid balance & fluid creep.Methods: The study design: pre & posttest research design. Setting: This study was implemented in general, trauma, obstetric and burn intensive care units (ICUs) at Assiut university Hospital-Assiut-Egypt. Subjects: 35 critical care nurses and 29 intensive care physicians were drawn from the previously mentioned ICUs. Methodology: A pre & posttest questionnaire of nurses’ and physicians’ knowledge, perception and satisfaction regarding fluid creep and fluid balance was adapted from the articles and was used in data collection before and after the application of scenario based teaching. This questionnaire was implemented on two phases (pre and after the teaching program). The data was collected from January 2018 to July 2018.Results: There is a considerable improvement in participants’ knowledge and perception concerning fluid balance and fluid creep after applying the scenario based teaching (p value < .001).Conclusions: Nowadays, nurses and physicians need advanced level of knowledge to be able to deal with the physiological changes that occur in critically ill.

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

scholarly journals Practice of Expert Critical Care Nurses in Situations of Prognostic Conflict at the End of Life

2006 ◽  
Vol 15 (5) ◽  
pp. 480-491 ◽  
Author(s):  
Catherine McBride Robichaux ◽  
Angela P. Clark
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Narrative Analysis ◽  
Critical Care Nurses ◽  
Realistic Picture ◽  
Inappropriate Treatment ◽  
Expert Nurses ◽  
End Of Life Decision

• Background Prolonging the living-dying process with inappropriate treatment is a profoundly disturbing ethical issue for nurses in many practice areas, including the intensive care unit. Despite the frequent occurrence of such distressing events, research suggests that critical care nurses assume a limited role in end-of-life decision making and care planning. • Objectives To explore the practice of expert critical care nurses in end-of-life conflicts and to describe actions taken when the nurses thought continued aggressive medical interventions were not warranted. • Methods A qualitative design was used with narrative analysis of interview data that had a temporal ordering of events. Interviews were conducted with 21 critical care nurses from 7 facilities in the southwestern United States who were nominated as experts by their colleagues. • Results Three recurrent narrative plots were derived: protecting or speaking for the patient, presenting a realistic picture, and experiencing frustration and resignation. Narratives of protecting or speaking for the patient concerned preventing further technological intrusion and thus permitting a dignified death. Presenting a realistic picture involved helping patients’ family members reframe the members’ sense of the potential for recovery. Inability to affect a patient’s situation was expressed in narratives of frustration and resignation. • Conclusions The transition from curative to end-of-life care in the intensive care unit is often fraught with ambiguity and anguish. The expert nurses demonstrated the ability and willingness to actively protect and advocate for their vulnerable patients even in situations in which the nurses’ actions did not influence the outcomes.

Eliciting critical care nurses’ beliefs regarding physical restraint use

2018 ◽  
Vol 26 (5) ◽  
pp. 1458-1472 ◽  
Author(s):  
Gemma Via-Clavero ◽  
Marta Sanjuán-Naváis ◽  
Marta Romero-García ◽  
Laura de la Cueva-Ariza ◽  
Gemma Martínez-Estalella ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Theory Of Planned Behaviour ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Control Beliefs ◽  
Physical Restraints ◽  
Planned Behaviour ◽  
Restraint Use ◽  
And Control

Background: Despite the reported harms and ethical concerns about physical restraint use in the critical care settings, nurses’ intention to apply them is unequal across countries. According to the theory of planned behaviour, eliciting nurses’ beliefs regarding the use of physical restraints would provide additional social information about nurses’ intention to perform this practice. Aim: To explore the salient behavioural, normative and control beliefs underlying the intention of critical care nurses to use physical restraints from the theory of planned behaviour. Research design: A belief elicitation study was conducted. Participants and research context: Twenty-six critical care nurses were purposively sampled across gender, work-shift patterns and professional experience in five intensive care units of three hospitals in Spain. Data were obtained from a nine-item open-ended questionnaire and a focus group. Deductive content analysis was performed. Ethical considerations: Ethical approval was obtained from the hospital ethics committee. Participants were assured their participation was voluntary. Findings: Nurses framed the use of restraints as a way of prioritising patients’ physical safety. They referred to contextual factors as the main reasons to justify their application. Nurses perceived that their decision is approved by other colleagues and the patients’ relatives. Some nurses started advocating against their use, but felt powerless to change this unsafe practice within an unfavourable climate. Control beliefs were linked to patients’ medical condition, availability of alternative solutions, analgo-sedation policies and work organisation. Discussion: Safety arguments based on the surrounding work environment were discussed. Conclusion: Nurses’ behavioural and control beliefs were related. Nurses should be trained in alternatives to physical restraint use. The impact of analgo-sedation protocols, relatives’ involvement, leadership support and intensive care unit restraint policies on physical restraint practices need to be revised. Further research is required to explore why nurses do not act with moral courage to change this harmful practice.

Pain in Intensive Care Unit: Italian critical care nurses' best practice

2021 ◽  
Vol 87 (7) ◽  
Author(s):  
Alessandro GALAZZI ◽  
Gian D. GIUSTI ◽  
Nicola PAGNUCCI ◽  
Stefano BAMBI ◽  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Best Practice ◽  
Critical Care Nurses
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