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Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making
Operations- and Intensive care Units, Ryhov County Hospital, Jönköping, Sweden.
Operations- and Intensive care Units, Ryhov County Hospital, Jönköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
2015 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 1, 16-24 p.Article in journal (Refereed) Published
Abstract [en]

Aim

The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation.

Background

Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation.

Design and method

A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis.

Findings

One theme emerged: ‘A complex nursing situation where the patient receives attention and which is influenced by the current care culture’. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present.

Conclusions and relevance to clinical practice

The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process.

Place, publisher, year, edition, pages
2015. Vol. 20, no 1, 16-24 p.
Keyword [en]
Decision-making; Intensive care; Nursing; Qualitative research; Ventilator weaning
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-25847DOI: 10.1111/nicc.12116ISI: 000348431600005PubMedID: 25269708Scopus ID: 2-s2.0-84921026062OAI: oai:DiVA.org:hj-25847DiVA: diva2:786204
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2017-01-03Bibliographically approved

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Citation style
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