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Preventing treatment interference: the nurse's role in maintaining technologic devices.

M B Happ1

  • 1Center for Advancing Care in Serious Illness, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-6069, USA.

Heart & Lung : the Journal of Critical Care
|January 15, 2000
PubMed
Summary

Critical care nurses skillfully prevent patients from disrupting life-sustaining equipment by assessing awareness and employing various strategies. This nursing responsibility is crucial for maintaining patient safety and treatment integrity in intensive care units.

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Area of Science:

  • Nursing Science
  • Critical Care Medicine
  • Human-Technology Interaction

Background:

  • Treatment interference, including device disruption, is a key reason for physical restraint use in critical care.
  • Processes for preventing device interference and managing care have not been fully analyzed.

Purpose of the Study:

  • To describe critical care nurses' strategies for preventing treatment interference in critically ill older adults.

Main Methods:

  • Conducted participant observation in medical and intermediate intensive care units.
  • Analyzed data using the constant comparative method and event analysis.

Main Results:

  • Nurses assess patient awareness, trustworthiness, and behavior to maintain devices, prioritizing endotracheal tubes, arterial catheters, and central venous catheters.

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  • Strategies include verbal explanations, distraction, deception, comfort measures, family involvement, physical restraints, and sedation.
  • Nurses consider patient cognitive status, mobility, strength, device necessity, and replacement difficulty.

    • Conclusions:

    • Nurses bear significant responsibility for maintaining technologic devices in the intensive care unit.
    • The study highlights the social context, nursing roles, and human-technology interaction in preventing treatment interference.
    • Further research and policy development are recommended.