The role of the registered nurse in artificial ventilation of critically ill patients
A literature review
DOI:
https://doi.org/10.14528/snr.2024.58.3.3172Keywords:
breathing, oral care, aspiration, pain, mobilityAbstract
Introduction: Due to their inability to perform basic life activities, artificially ventilated critically ill patients represent the highest level of vulnerability and require the highest standards of nursing care. The aim of this literature review was to examine the role of the registered nurse in the artificial ventilation of critically ill patients.
Methods: A review of the scientific literature was conducted in March 2022 in the PubMed, Cobbis and Sage Journals databases. The literature search was based on advanced keywords in English and Slovenian, namely: breathing; oral care; aspiration; pain; mobility. The search strategy was based on the following inclusion criteria: fully accessible texts, scientific journal, peer-reviewed publication, Slovenian or English language, period 2012–2022. The results were analysed using thematic analysis.
Results: 15 relevant hits out of a total of 638 were included in the final analysis. The literature review included five observational studies, three cross-sectional studies, two phenomenological studies, one causalcomparative study, and four systematic literature reviews. The results were arranged into six categories: (1) quality nursing care, (2) oral care, (3) aspiration, (4) pain, (5) communication, and (6) mobility.
Discussion and conclusion: The results show that the role of a registered nurse in the artificial ventilation of critically ill patients is complex and demanding. A registered nurse is expected to continuously train and adapt to current conditions, work under demanding conditions, and perform procedures and interventions that are an important part of high quality nursing care.
Downloads
Metrics
References
Alba, R. S., Orlando, A., Diana, C. R., Carlos, F., Reyes, A., Espitia, C., Pizarro, C., Gea, K., Castillo, V. R. & Mauricio, O. (2021). Invention and pilot study of the efficacy and safety of the supratube device in continuous supraglottic aspiration for intubated and mechanically ventilated patients. Medical Devices, 14, 287–297. https://doi.org/10.2147/MDER.S328485 PMid:34675695; PMCid:PMC8502029
Afify, N., Warda, Y. M., & Fatma, S. A. (2018). Behavioral and physiological indicators of pain during nociceptive procedures among mechanically ventilated patients at a University Hospital in Cairo. Journal of Health, Medicine and Nursing, 47, 1–10. https://www.iiste.org/Journals/index.php/JHMN/article/view/41156/42319
Ayasrah, S. (2016). Care-related pain in critically ill mechanically ventilated patients. Anaesthesia and Intensive Care, 44(4), 458–465. https://doi.org/10.1177/0310057X1604400412 PMid:27456175
Aziza, S., & Muayyad, M. A. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: Integrative review. Journal of Research in Nursing, 23(7), 614–630. https://doi.org/10.1177/1744987118785987 PMid:34394481
Arsyawina, A., Mardiyono, M., & Sarkum, S. (2014). Critical- Care Pain Observation Tool (CPOT) and wong-baker faces pain rating scale in measuring pain level of patient with mechanical ventilation. Jurnal Riset Kesehatan, 3(1), 507–513. https://doi.org/10.31983/jrk.v3i1.240
Bassi, G. L., Aguilera Xiol, E., Pagliara, F., Hua, Y., & Torres, A., (2017). Body position and ventilator-associated pneumonia prevention. Seminars in Respiratory and Critical Care Medicine, 38(3), 371–380. https://doi.org./10.1055/s-0037-1603111 PMid:28578559
Bozan, S., & Guven, S. D. (2020). Evaluation of knowledge and behavior of nurses working in intensive care units for endotracheal aspiration application. Journal of Surgery and Medicine, 4(4), 296–300. https://doi.org/10.28982/josam.693310
Booth, A., Papaioannou, D., & Sutton, A. (2012). Systematic approaches to a successful literature review. SAGE Publications. Drews, F., & Doig, A. (2013). Evaluation of a configural vital signs display for intensive care unit nurses. Human Factors, 6(3), 433–615. https://doi.org/10.1177/0018720813499367 PMid:24930176
Eder, T. (2019). E-arly Mobility of mechanically ventilated adult medical-surgical critical care patients [DNP Project, University of Maryland]. UMB Digital Archive University of Maryland, Baltimore. http://hdl.handle.net/10713/9503
Else, L. (2015). Lived experiences of professional nurses caring for mechanically ventilated patients [Masters Thesis, Nelson Mandela Metropolitan University]. South East Academic Library System - SEALS. http://hdl.handle.net/10948/8295
Gopalakrishan, M. (2018). Effectiveness of music therapy on pain and physiological parameters among patients on mechanical ventilation at KMCH, Coimbatore [Masters thesis, KMCH College of Nursing, Coimbatore]. http://repository-tnmgrmu.ac.in/11579/
Goñi-Viguria, E., Yoldi-Arzoz, L., Casajús-Sola, T., Aquerreta- Larraya, P., Fernández-Sangil, E., Guzmán-Unamuno, B., & Moyano-Berardo, M. (2018). Respiratory physiotherapy in intensive care unit: Bibliographic review. Enfermería Intensiva, 29(4), 168–181. https://doi.org/10.1016/j.enfi.2018.03.003 PMid:29910086
Hideki, O., Hideki, K., Makoto, S., Kazuaki, I., Satoshi, F., & Hiroko, S. (2015). Effect of early mobilization on discharge disposition of mechanically ventilated patients. The Society of Physical Therapy Science, 27(3), 859–864. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395731/ PMid:25931747
Hellyer, T., Ewan, V., & Wilson, P. (2016). The Intensive Care Society recommended bundle of interventions for the prevention of ventilator-associated pneumonia. Journal of the Intensive Care Society, 17(3), 238–243. https://doi.org/10.1177/1751143716644461 PMid:28979497; PMCid:PMC5606527
Imad, T., Asmar, Belal, M., Alrajoub, Omar, H., Almahmoud, Dina, N., Nakhleh, Sara, I., Makharzeh, & Yazeed, M. (2020). Nurses' attitude, behavior, and knowledge regarding protective lung strategies of mechanically ventilated patients. Critical Care Nursing Quarterly, 43(3), 274–285. https://doi.org/10.1097/CNQ.0000000000000312 PMid:32433068
Jinxia, J., Sijia, Z., Peng, H., Qian, W., Yan, S., Xia, D., & Songjuan, Y. (2022). Knowledge, attitude, and perceived barriers of newly graduated registered nurses undergoing standardized training in intensive care unit toward early mobilization of mechanically ventilated patients: A qualitative study in Shanghai. Frontiers in Public Health, 9, Article 802524. https://doi.org/10.3389/fpubh.2021.802524 PMid:35087787; PMCid:PMC8787086
Kefalotse, D., Sambulelwe, S., Moleki, M. M., & Thupayagale- Tshweneagae, G. (2016). Exploring communication challenges between nurses and mechanically ventilated patients in the intensive care unit: A structured review. Worldviews on Evidence-Based Nursing, 13(3), 197–206. https://doi.org/10.1111/wvn.12146 PMid:26860230
Kimberly, P. E., & Guido-Sanz, F. (2019). Oral care practices in non-mechanically ventilated intensive care unit patients: An integrative review. Journal of Clinical Nursing, 28(13/14), 2462–2471. https://doi.org/10.1111/jocn.14829 PMid:30793402
Kalender, Smajlović, S. (2021). Etične dileme pri izvajanju zdravstvene nege v enoti intenzivne terapije: pregled literature. Obzornik zdravstvene nege, 53(2), 157–168. https://doi.org/10.14528/snr.2019.53.2.222
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Labuschagne, L. (2014). Gehalteverpleging van meganiesgeventileerde pasiente [Master Thesis, University of Johannesburg]. UJC Content.
Lev, A., Aied, A. S., & Arshed, S. (2014). The effect of different oral hygiene treatments on the occurrence of ventilator associated pneumonia (VAP) in ventilated patients. on the occurrence of ventilator associated pneumonia (VAP) in ventilated patients. Journal of Infection Prevention, 16(2), 76–81. https://doi.org/10.1177/1757177414560252 PMid:28989405; PMCid:PMC5074176
Linki, Q., Xiaoxia, G., Chunyan, N., Xin, L., & Miao, Z. (2022). Research on Effects of effects of oropharyngeal aspiration on incidence of ventilator-associated pneumonia in patients with cerebral hemorrhage in ICU. Journal of Healthcare Engineering, 2022(1), Article 6433666. https://doi.org/10.1155/2022/6433666 PMid:35087650
Lužnik, I., & Šega, A. (2016). Nadzor nad bolnikom na mehanski ventilaciji. Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije. Sekcija medicinskih sester in zdravstvenih tehnikov na internistično infektološkem področju.
Mahmoud, A., Mosleh, S. M., & Habashneh, S. S. (2018). Nurses' perception and attitudes towards oral care practices for mechanically ventilated patients. Saudi Medical Journal, 39(4), 379–385. https://doi.org/10.15537/smj.2018.4.21749 PMid:29619490; PMCid:PMC5938652
Manal, S., Maysoon, S., Abdalrahim, A. M., Hamdan-Mansour, S., & Shahnaz, M. (2014). Pain among mechanically ventilated patients in critical care units. Journal of Research in Medical Sciences, 19(8), 726–732. https://doaj.org/article/61798a4b298e4f5884c264323ee5598f PMid:25422657
Marzieh, M., Mohammadreza, S., Ardakani, F., Dehghan, R., Roya, D., Reza, D., & Azita, J. (2019). Quality of nurses'communication with mechanically ventilated patients in a cardiac surgery intensive care unit. Investigacion y Educacion en Enfermeria, 37(2), Article e02. https://doi.org/10.17533/udea.iee.v37n2e02 PMid:31487439
Melek, Y., Zehra, D., & Semiha, A.(2013). Assessment of oral care needs of patients treated at the intensive care unit. Journal of Clinical NursingVolume 22(19/20), 2734–2747. https://doi.org/10.1111/jocn.12035 PMid:23534462
Naue, W. D. S., Herve, B. B.,Vieira, F. N., Deponti, G. N., Martins, L. F., Dias, A. S., & Vieira, S. R. R. (2019). Comparison of bronchial hygiene techniques in mechanically ventilated patients: A randomized clinical trial. Revista Brasileira de Terapia Intensiva, 31(1), 39–46. https://doi.org/10.5935/0103-507X.20190005 PMid:30892477
Oren, A., Slutsker, E., & Melnikov, S. (2019). Nurses' perceptions of pain management adequacy in mechanically ventilated patients. Journal of Clinical Nursing, 28(15/16), 2946–2952. https://doi.org/10.1111/jocn.14896 PMid:31013381
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. British Medical Journal, 372, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Polit, D. F., & Beck, C. T. (2018). Esentials of nursing research: Appraising evidence for nursing practice (9th ed.). Lippincott Williams & Wilkins.
Rachel, B. (2020). Oral care and ventilator associated pneumonia prevention. [Master Thesis, University of Texas at Tyler]. MSN Capstone Projects, 40. http://hdl.handle.net/10950/2635
Roberts, M., & Wellman, A., (2018). Safety practices used by critical care nurses in the care of patients receiving mechanical ventilation. [Study, University of Kentucky]. Digital Commons. https://digitalcommons.murraystate.edu/postersatthecapitol/2008/UK/21/
Sanniya, K. G., Arslaan, J., Aqsa, C., Abdus, S. K., & Khawaja, J. M. (2020). Knowledge and attitudes of Pakistani intensive care unit nurses regarding oral care delivery to mechanically ventilated patients. The Journal of the Pakistan Medical Association, 70(7), 1203–1208. https://doi.org/10.5455/jpma.5630 PMid:32799274
Scherzer, R. (2010). Subglottic secretion aspiration in the prevention of ventilator-associated pneumonia: A review of the literature. Dimensions of Critical Care Nursing, 29(6), 276–280. https://doi.org./10.1097/DCC.0b013e3181f0bfd1 PMid:20940579
Sibilla, A., Nydahl, P. N., & Greco, N. (2017). Mobilization of mechanically ventilated patients in Switzerland. Journal of Intensive Care Medicine, 35(1), 55–62. https://doi.org/10.1177/0885066617728486 PMid:28847238
Sobota, M. (2021). Early mobilization in invasive mechanically ventilated ICU Patients: A quality improvement project [Dissertation Thesis, Creighton University]. Creighton Digital Repository, ID 991005932846102656 https://dspace2.creighton.edu/xmlui/handle/10504/129776
Syaukia, A., Santoso, B., & Sudirman, S. (2018). The comparison of the effect of honey and chlorhexidine in preventing ventilator associated pneumonia in patients on mechanical ventilaton. Belitung Raya Foundation, 4(2), 161–167. https://doi.org/10.33546/bnj.355
Wakiuchi, J., Ferreira Fontes, M. C., & Ferreira Papa, M. A., (2014). Higiene oral em pacientes sob ventilação mecânica: Revisão integrativa. A Revista de Enfermagem UFPE, 8(7), 2479–2486. https://doi.org/10.5205/1981-8963-v8i7a9940p2479-2486-2014
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMid:24141714
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Slovenian Nursing Review
This work is licensed under a Creative Commons Attribution 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.