A critical analysis of the philosophy, knowledge and theory underpinning mouth care practice for the intensive care unit patient

Exploring the competency of the Jordanian intensive care nurses towards endotracheal tube and oral care practices for mechanically ventilated patients: an observational study

Oral care is an important feature of nursing; it is known that oropharynx is considered the main reservoir of bacterial colonization, so the removal of oral infection is a major duty of all health care providers, particularly nurses. We performed this study to explore endotracheal tube and oral care practices for mechanically ventilated patients of Jordanian intensive care nurses, and to study Jordanian intensive care nurses' practices during, prior to, and post endotracheal tube and oral care for mechanically ventilated patients. Endotracheal tube and oral care of Jordanian intensive care nurses for mechanically ventilated patients was compared with recommendations for endotracheal tube and oral care of American Association of Critical Care Nurses and guidelines of Centers for Disease Control and Prevention. Non- participant structured observational design was conducted using a 24 -item structured observational schedule. The findings show that nurses different in their oral care practices; did not follow American Association of Critical Care Nurses recommendations; and therefore delivered lower-quality oral care than predictable. Important inconsistencies were observed in the nurses' hyperoxygenation, respiratory assessment techniques and infection control practices.

[The meaning of standardized language NANDA-NIC-NOC intensive care nurses in Madrid: a phenomenological approach]

Nursing standardized language is a tool that makes it possible to integrate a theoretical framework of problem identification, interventions and outcomes in care. Its use in the difference care settings is varied. In the case of intensive care units, it is necessary to study the implications that integration of this language would have in nursing area.

OBJECTIVE

To describe the meaning of standardized NANDA-NIC-NOC language for the nurses working in Intensive Care Units in Madrid.

METHOD

A phenomenological qualitative study was conducted.

INCLUSION CRITERIA

ICU in Madrid of nurses with one year or more experience at the time of the study who were working in the ICU.

SAMPLE

Purposive and Snowball sampling technique.

DATA COLLECTION

Unstructured interviews, personal documents (letters, diaries). Interviews were recorded and transcribed verbatim for later analysis.

ANALYSIS

Giorgi proposal. Identifying meaning units, groups of common senses and themes.

RESULTS

Three themes made up the meaning of standardized language in intensive care nursing. "Living integrating 2 sides of the same coin", "living a conceptual imposition", and "living a development opportunity and professional autonomy".

CONCLUSIONS

There is a gap in the theory of language and its clinical application. Nurses report feeling imposition of a specific conceptual language. This creates the construction of a hierarchy between nurses based on the use of NANDA-NIC-NOC. Even so, the standardized language is experienced as a professional development opportunity.

Lifelong learning--the key to competence in the intensive care unit?

With continual advances in technology and changes in medical and nursing practice there is a need to continue professional development whilst working within the Intensive Care environment. This paper aims to consider why and how nurses working within the Intensive Care environment learn knowledge and skills. To explore nurses' experiences, a qualitative approach using a semi-structured questionnaire comprising open questions was used. The questionnaires were then analysed using line by line coding. The findings revealed that intensive care nurses learn knowledge and skills continually through a lifelong learning process in order to become a competent practitioner. Three themes were identified within this process: learning, opportunity, and outcome, all being affected by three factors: internal, external and patient-related. It is suggested that in order to organise and support effective learning, there needs to be an awareness of all of these factors and to be able to overcome the negative aspects to enhance the learning experience for all. The ultimate outcome of learning for the intensive care nurses was to practice competently in order to deliver high quality patient care.