Interdependent nursing interventions as sensitive indicators of quality - Care in noninvasive mechanical ventilation

Authors

DOI:

https://doi.org/10.29352/mill0220.28233

Keywords:

interdependent interventions; NIMV; constraints, ISQ, competencies

Abstract

Introduction: The Interdependent Nursing Interventions (INI) in Non-Invasive Mechanical Ventilation (NIMV) for the critically ill are essential for quality in health, so it is important to recognize the process indicators (IP) that promote the visibility of these care interventions.

 Objectives: To identify the INI for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed to be Process Indicators, Quality Sensitive (IPSQ) to care, and their relationship with professional variables.

Methods: Exploratory, quantitative and descriptive study, based on the analysis of the answers to a questionnaire prepared for this purpose, in a sample of 76 nurses, of urgency and intensive medicine, mostly female (82.9%), aged between 36 and 45 years (51.3%).

Results: The IIEs for critically ill patients with NIMV, which, due to their enforceable consistency, are assumed to be ISQs for care, are: “the patient is monitored according to the recommendations” and “(…) their collaboration is informed and requested” and the most felt constraints were: “presence of excessive secretions (…)”, “the occurrence of cardiac arrest is a contraindication” and “the patient's level of consciousness influences success (…)”. Statistically significant relationships were found between: the IIE “use of sedation” and length of service, and the constraint “level of consciousness” and the variables: specific training and length of service.

Conclusion: A protocol of action in NIMV is essential for standardization of care.

 

Downloads

Download data is not yet available.

References

ACI. (2014). Non-invasive Ventilation Guidelines for Adult Patients with Acute Respiratory. Agency for Clinical Innovation Failure.https://aci.h ealth.nsw.gov.au/data/assets/pdf_file/0007/239740/ACI14_Man_NIV_1-2.pdf

Alves, J. C. F., Fank, A., Souza, L. P. de, & Lima, M. G. de. (2018). O papel do enfermeiro na oxigenoterapia: Revisão narrativa da literatura. Journal of Health & Biological Sciences, 6(2), 176-181. https://dx.doi.org/10.12662/2317-3076jhbs.v6i2.1242.p176-181.2018

Costa, J. C., Machado, J. N., Costa, J., Fortuna, J., Gama, J., & Rodrigues, C. (2018). Ventilação Não Invasiva: Experiência de um Serviço de Medicina Interna. Medicina Interna, 25, 18–22. https:// doi.org/10.24950/rspmi/original/78/1/2018

D’Orazio, A, Dragonetti A, Campagnola G, Garza C, Bert F, Frigerio S. (2018). Patient Compliance to NonInvasive Ventilation in Sub-IntensiveCare Unit: An Observational Study. Nursing Crit Care 11(1), 1-4.

http://doi.org/10.5812/ccn.65300

Davidson, A. C., Banham, S., Elliott, M., Kennedy, D., Gelder, C., Glossop, A., Church, A. C., Creagh-Brown, B., Dodd, J. W., Felton, T., Foëx, B., Mansfield, L., McDonnell, L., Parker, R., Patterson, C. M., Sovani, M., Thomas, L., & BTS Standards of Care Committee Member, British Thoracic Society/Intensive Care Society Acute Hypercapnic Respiratory Failure Guideline Development Group, On behalf of the British Thoracic Society Standards of Care Committee (2016). BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults. Thorax, 71, ii1–ii35. https://doi.org/10.1136/thoraxjnl-2015-208209

Ergan, B., Nasilowski, J., & Winck, J. (2018). “How should we monitor patients with acute respiratory failure treated with nonivasive ventilation”. European Respiratory Review, 27(148), 1-17. http://doi.org/ 10.1183/16000617.0101-2017

Fernandes, S., Veiga-Branco, M., & Rodrigues, P. (2019). The critically ill person submitted to non-invasive ventilation in an emergency department. Revista de Enfermagem Referência, 4(22), 13-22. https:// doi.org/10.12707/RIV19027

McCance, T., Telford, L., Wilson, J., Macleod, O., & Dowd, A. (2012). Identifying key performance indicators for nursing and midwifery care using a consensus approach. Journal of clinical nursing, 21(7-8), 1145–1154. https://doi.org/10.1111/j.1365-2702.2011.03820.x

Migoto, M. & Oliveira, R. & Freire, M. (2022). Validação de indicadores para monitoramento da qualidade do pré-natal. Escola Anna Nery. 26. https://doi.org/10.1590/2177-9465-EAN-2021-0262

Ministério da Saúde. (2015). Despacho n.º 5613/2015 de 27 de maio: A Estratégia Nacional para a Qualidade e na Saúde 2015-2020. Diário da República. 2.ª série, n.º 102. https://dre.pt/application/file/67318639

Ordem dos Enfermeiros. (2015). Estatuto da Ordem dos Enfermeiros e REPE, Ordem dos Enfermeiros. https:// www.ordemenfrmeiros.pt/arquivo/publicacoes/Documents/nEstatuto_REPE_29102015_VF_site.pdf

Ordem dos Enfermeiros. (2016). Classificação Internacional para a Prática de Enfermagem versão 2015. https://futurosenf.files.wordpress.com/2017/04/cipe_2015.pdf

Ordem dos Enfermeiros. (2021). Estatística de Enfermeiros. Ordem Dos Enfermeiros. https://www.ordemenfermeiros.pt/arquivo/bu/estatistica/acumulado/2021_AnuarioEstatisticos_Nacional.xlsx

Pinto, C. J. C. & Sousa, P. M. L. (2017). Ventilação Não Invasiva: desenvolvimento de linhas orientadoras recorrendo à metodologia Delphi. In M. Dixe, P. Sousa & P. Gaspar (Coords.) (2017). Construindo conhecimento em enfermagem à pessoa em situação crítica (pp. 105-123). Leiria, Portugal: Instituto Politécnico de Leiria. http://hdl.handle.net/10400.8/2884

Raurell-Torredà, M., Romero-Collado, A., Rodríguez-Palma, M., Farrés-Tarafa, M., Martí, J. D., Hurtado-Pardos, B., Peñarrubia-San Florencio, L., Saez-Paredes, P., & Esquinas, A. M. (2017). Prevention and treatment of skin lesions associated with non-invasive mechanical ventilation. Recommendations of experts. Enfermeria intensiva, 28(1), 31–41. https://doi.org/10.1016/j.enfi.2016.12.001

Raurell-Torredà, M., Argilaga-Molero, E., Colomer-Plana, M., Ródenas-Fransico, A., Ruiz-Garcia, M. T., & Uya Muntaña, J. (2017). Optimising non-invasive mechanical ventilation: Which unit should care for these patients? A cohort study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 30(4), 225–233. https://doi.org/10.1016/j.aucc.2016.08.005

Rochwerg, B., Brochard, L., Elliott, M. W., Hess, D., Hill, N. S., Nava, S., Navalesi, P., Antonelli, M., Brozek, J., Conti, G., Ferrer, M., Guntupalli, K., Jaber, S., Keenan, S., Mancebo, J., Mehta, S., & Raoof, S. (2017). Official ERS/ATS clinical practice guidelines: Noninvasive ventilation for acute respiratory failure. European Respiratory Journal, 50(2). https://doi.org/10.1183/13993003.02426-2016

Raurell-Torredà, M., Argilaga-Molero, E., Colomer-Plana, M., Ródenas-Francisco, A., & Garcia-Olm, M. (2019). Nurses' and physicians' knowledge and skills in non-invasive ventilation: Equipment and contextual influences. Enfermeria intensiva, 30(1), 21–32. https://doi.org/10.1016/j.enfie.2018.04.004

Observatório Nacional das Doenças Respiratórias. (2018). Panorama das doenças respiratórias em Portugal: O estado da saúde em Portugal. Observatório Nacional das Doenças Respiratórias

Santos, R. K. M. dos, Nepomuceno, F. C. L., & Andrade, F. L. J. P. de. (2020). Uso de ventilação não invasiva em pacientes críticos: Endema doença pulmonar obstrutiva crônica e edema agudo de pulmão cardiogênico. Novas edições Acadêmicas.

Seiffert, L. S., Wolf, L. D. G., Silvestre, A. L., Mendonça, T. R., &Cruz, E. D., Ferreira, M. M. F., & Amaral, A. F. S., (2020). Validação de indicadores de efetividade hospitalar na dimensão cuidado centrado no doente. Revista de Enfermagem Referência, 5(2), e19098. doi:10.12707/RIV19098

Vieira, J., Santos, M. R., Pires, R., & Pereira, F. (2021). Quality indicators of professional practice of nurses: the caregiver role. Millenium - Journal of Education, Technologies, and Health, 2(16), 41-48. DOI: https://doi.org/10.29352/mill0216.24785

Published

2023-03-28

How to Cite

Fidalgo Fernandes, A. F., & Romão da Veiga Branco, M. A. . (2023). Interdependent nursing interventions as sensitive indicators of quality - Care in noninvasive mechanical ventilation. Millenium - Journal of Education, Technologies, and Health, 2(21), e28233. https://doi.org/10.29352/mill0220.28233

Issue

Section

Life and Healthcare Sciences