Nurse-led weaning from ventilation and extubation in the paediatric cardiothoracic intensive care unit

J Webster1

  • 1Paediatric Intensive Care Unit, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP. julia.webster1@virgin.net

Insights

This study explored enhancing paediatric intensive care nurses' roles to improve patient care quality. It investigated ventilation weaning practices in children post-cardiac surgery, detailing protocol development and implementation strategies.

Area of Science:

  • Pediatric Intensive Care Nursing
  • Cardiac Surgery Patient Management
  • Mechanical Ventilation Weaning

Background:

  • Enhancing the role of paediatric intensive care nurses is crucial for improving patient outcomes.
  • Effective weaning from mechanical ventilation in children post-cardiac surgery requires optimized clinical practices.

Purpose of the Study:

  • To present an initiative for expanding the role of paediatric intensive care nurses.
  • To promote enhanced quality patient care through improved ventilation weaning practices.
  • To investigate current practices in weaning children from ventilation after cardiac surgery.

Main Methods:

  • A point prevalence study was conducted to assess current ventilation weaning practices.
  • Development and implementation of a clinical protocol.
  • Audit of practice, education, and training initiatives were undertaken.

Main Results:

  • The study involved the development and implementation of a clinical protocol for ventilation weaning.
  • Practices were audited, and education/training programs were conducted.
  • A change in practice was implemented and discussed.

Conclusions:

  • Expansion of the paediatric intensive care nurse role can enhance patient care quality.
  • A structured approach involving protocol development, audit, and education is effective for improving ventilation weaning practices.
  • Further research is recommended to build upon these findings.

Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.
Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...