Terminal weaning from mechanical ventilation: ethical and practical considerations for patient management

1992 ◽  
Vol 1 (3) ◽  
pp. 52-56 ◽  
Author(s):  
ML Campbell ◽  
RW Carlson
Keyword(s):  
Mechanical Ventilation ◽  
Healthcare Provider ◽  
Patient Management ◽  
Healthcare Providers ◽  
Patient Rights ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

Decisions to withdraw life-sustaining therapy are being made more often as patients and healthcare providers increase their awareness of patient rights. The process of withdrawal of mechanical ventilation must be conducted in a humane fashion. An understanding of the ethical, legal and practical considerations for patient management during this type of intervention will enhance the ability of the healthcare provider to participate.

Case studies in terminal weaning from mechanical ventilation

1993 ◽  
Vol 2 (5) ◽  
pp. 354-358 ◽  
Author(s):  
ML Campbell
Keyword(s):  
Mechanical Ventilation ◽  
Supportive Care ◽  
Case Studies ◽  
Significant Others ◽  
Care Team ◽  
Patient Specific ◽  
Healthcare Team ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

Terminal weaning, withdrawal of mechanical ventilation when the patient is not expected to survive the process, must not be burdensome to the patient or significant others. The healthcare team must individualize the weaning process, considering the physiologic comfort of the patient and the psychoemotional comfort of both the patient and family. The following case studies illustrate variations in a method for terminal weaning that are patient-specific and are based on the experience of a supportive care team.

Weaning from mechanical ventilation: concept development

1994 ◽  
Vol 3 (6) ◽  
pp. 416-420 ◽  
Author(s):  
AR Knebel ◽  
ME Shekleton ◽  
S Burns ◽  
JM Clochesy ◽  
SK Hanneman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Conceptual Framework ◽  
Ventilator Weaning ◽  
Concept Development ◽  
National Study ◽  
Future Research ◽  
Weaning From Mechanical Ventilation ◽  
Difficult Weaning ◽  
Patient Will ◽  
Terminal Weaning

This article, the first in a series, is written to clarify the process of weaning from mechanical ventilation and to promote the development of a common language for understanding the complex weaning process. The Third National Study Group on Weaning From Mechanical Ventilation proposes a conceptual model and definitions that will provide a framework for future research on this important topic. This conceptual framework describes the preweaning phase, the weaning process, and the outcome phase of mechanical ventilation. Potential outcomes are completion of weaning, lack of completion, and terminal weaning. The weaning decision continuum incorporates: (1) when and how to begin the weaning process, (2) how to select therapies to assist with difficult weaning and chart progress during weaning, and (3) when to stop weaning if progress is no longer being made. An inherent assumption of this model is that each patient will display unique responses to the weaning process. The proposed conceptual framework and definitions provide a foundation for developing clinical practice guidelines and for guiding future ventilator weaning research.

Patient responses during rapid terminal weaning from mechanical ventilation

1999 ◽  
Vol 27 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Margaret L. Campbell ◽  
Kathryn S. Bizek ◽  
Mary Thill
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning ◽  
Patient Responses

Terminal Weaning From Mechanical Ventilation

1994 ◽  
Vol 5 (4) ◽  
pp. 523-533 ◽  
Author(s):  
MAUREEN E. SHEKLETON ◽  
SUZANNE M. BURNS ◽  
JOHN M. CLOCHESY ◽  
SANDRA K. GOODNOUGH HANNEMAN ◽  
GAIL L. INGERSOLL ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

Terminal weaning from mechanical ventilation

1999 ◽  
Vol 27 (1) ◽  
pp. 9-10 ◽  
Author(s):  
Ganesh Krishna ◽  
Thomas A. Raffin
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

Terminal Weaning from Mechanical Ventilation

1996 ◽  
Vol 19 (3) ◽  
pp. 36-51 ◽  
Author(s):  
Frederick J. Tasota ◽  
Leslie A. Hoffman
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

scholarly journals What is stopping us? An implementation science study of kangaroo care in British Columbia’s neonatal intensive care units

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Coutts ◽  
Alix Woldring ◽  
Ann Pederson ◽  
Julie De Salaberry ◽  
Horacio Osiovich ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Provider ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Healthcare Providers ◽  
Neurodevelopmental Outcomes ◽  
Kangaroo Care ◽  
Optimal Care ◽  
Barriers And Enablers ◽  
Provider Beliefs

Abstract Background The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaroo Care (KC) is an evidence-based developmental care strategy that has been shown to be associated with improved short and long term neurodevelopmental outcomes for preterm infants. Despite evidence for best practice, uptake of the practice of KC in resource supported settings remains low. The aim of this study was to identify and describe healthcare providers’ perspectives on the barriers and enablers of implementing KC. Methods This qualitative study was set in 11 NICUs in British Columbia, Canada, ranging in size from 6 to 70 beds, with mixed levels of care from the less acute up to the most complex acute neonatal care. A total of 35 semi-structured healthcare provider interviews were conducted to understand their experiences providing KC in the NICU. Data were coded and emerging themes were identified. The Consolidated Framework for Implementation Research (CFIR) guided our research methods. Results Four overarching themes were identified as barriers and enablers to KC by healthcare providers in their particular setting: 1) the NICU physical environment; 2) healthcare provider beliefs about KC; 3) clinical practice variation; and 4) parent presence. Depending on the specific features of a given site these factors functioned as an enabler or barrier to practicing KC. Conclusions A ‘one size fits all’ approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers to its uptake. Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for KC in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels.

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