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Published on: September 24, 2020
Protective lung strategies: A cross sectional survey of nurses knowledge and use in the emergency department
Sarah Cornish1, Rochelle Wynne2, Sharon Klim3
1Emergency Department, Sunshine Hospital,Furlong Road, St. Albans Victoria 3021, Australia.
Background:
Mechanical ventilation (MV) is commonly used in emergency departments (EDs). Protective lung strategies (PLS), comprising of low tidal volume (6mL/kg), control of oxygen and plateau pressures, and administration of positive end expiratory pressure (PEEP) has been shown to reduces the risks associated with MV but there is little evidence exists about nurses' knowledge or application of PLS. Our aim was to explore nurses knowledge and application of PLS in Australian EDs.
Methods:
Descriptive, exploratory design utilising an online questionnaire. A convenience sample was recruited via the College of Emergency Nursing Australasia mailing list and secondary snowball sampling was used to optimise response rate.
Results:
There were 157 participants. PLS are being used in most EDs (n=104, 75%) and clinical practice guidelines (CPG) are often available (n=86, 62%). Most ED ventilators are capable of implementing PLS, but measurement of plateau pressures was infrequent (n=46%). Participants demonstrate appropriate knowledge, but reported varying levels of confidence and perceived autonomy when implementing PLS in the ED.
Conclusion:
PLS are being used in Australian EDs, aligning with best available evidence. Nursing staff have good levels of PLS knowledge. Development of an evidence-based CPG may improve confidence when implementing PLS and may pave the way for ED nurses to expand their scope of practice.
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