1
|
Tasota FJ, Kress TL, Conlin TL, Scarmack NM. Nasal cannula or high-flow oxygen for patients with COPD in acute respiratory distress? Nursing 2021; 51:52-57. [PMID: 33885433 DOI: 10.1097/01.nurse.0000743096.13461.b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT There may be some confusion regarding the use of supplemental oxygen in patients with chronic obstructive pulmonary disease (COPD) who are experiencing acute respiratory distress. This article addresses a common nursing misconception regarding the use of high-flow oxygen administration via non-rebreather masks instead of low-flow oxygen administration via nasal cannulas in patients with COPD who are in acute respiratory distress, an issue that was investigated in a simulation education exercise and survey of the nursing staff at the authors' facility.
Collapse
Affiliation(s)
- Frederick J Tasota
- At the University of Pittsburgh Medical Center Presbyterian Hospital in Pittsburgh, Pa., Frederick J. Tasota is an RN educator and Terri L. Kress , Tiffany L. Conlin , and Natalie M. Scarmack are advanced clinical education specialists
| | | | | | | |
Collapse
|
2
|
Desalu OO, Aladesanmi AO, Ojuawo OB, Opeyemi CM, Ibraheem RM, Suleiman ZA, Oyedepo OO, Adesina KT, Oloyede T, Sanya EO. Development and validation of a questionnaire to assess the doctors and nurses knowledge of acute oxygen therapy. PLoS One 2019; 14:e0211198. [PMID: 30716074 PMCID: PMC6361442 DOI: 10.1371/journal.pone.0211198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background Prescription and administration of oxygen in emergencies by healthcare providers are reported to be inappropriate in most settings. There is a huge gap in the knowledge of health care providers on various aspects of oxygen therapy, and this may be a barrier to optimal oxygen administration. Hence, it is essential to ascertain providers’ knowledge of acute oxygen therapy so that appropriate educational interventions are instituted for better delivery. There is no available validated instrument to assess knowledge of acute oxygen therapy. The study aimed to develop, validate and evaluate the test-retest reliability of a questionnaire to determine the doctors and nurses understanding of acute oxygen therapy. Methods This study involved the development of the questionnaire contents by a literature review, assessment of face validity (n = 5), content validity, using a panel of experts (n = 10), item analysis and test-retest reliability among a sample (n = 121) of doctors and nurses. Results Face validity indicated that the questionnaire was quick to complete (10–15 min), most items were easy to follow and comprehensible. The global content validity index (S-CVI) was 0.85. The test-retest reliability statistics showed a kappa coefficient of 0.546–0.897 (all P<0.001) and percentage agreement of 80–98.3% indicating high temporal stability in the target population. In total, 90% of the items fulfilled the reliability acceptance criteria. Item discrimination analysis showed that most questions were at an acceptable level. The final questionnaire included 37 item questions and eight sections. Conclusion The designed questionnaire is a reliable and valid tool for assessing knowledge of acute oxygen therapy among doctors and nurses.
Collapse
Affiliation(s)
- Olufemi O. Desalu
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
- * E-mail:
| | | | - Olutobi B. Ojuawo
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | | - Zakari A. Suleiman
- Department of Anaesthesia, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | - Kikelomo T. Adesina
- Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Taofeek Oloyede
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Emmanuel O. Sanya
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | |
Collapse
|
3
|
Wen Z, Chen J, Bian L, Xie A, Peng M, Li M, Wei L. The nasal oxygen practice in intensive care units in China: A multi-centered survey. PLoS One 2018; 13:e0203332. [PMID: 30161225 PMCID: PMC6117075 DOI: 10.1371/journal.pone.0203332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/17/2018] [Indexed: 01/09/2023] Open
Abstract
Background Nurses frequently administer nasal oxygen therapy for patients in intensive care units (ICUs). However, little is known about the current status, nurses’ management and perception on the nasal oxygen therapy in China. Therefore, we aimed to investigate the nasal oxygen practice of ICUs in China to provide insights into future direction. Methods A cross-sectional survey on 10 hospitals was conducted. A self-designed questionnaire was administered to ICU nurses. Descriptive statistics, univariate, and multiple stepwise regression analyses were performed to analyze the respondents’ questionnaires. Results A total of 580 respondents with a response rate of 96.67% were included in this study. The average correct answer rate was 58.28%. The current status of nasal oxygen administration in ICUs in Chinese hospitals lagged behind the recommendations of related guidelines. Nurses in China were eager to learn about the updated knowledge on oxygen therapy. The gender, age, clinical experience, degree, job title, and classification of working hospitals were not related to the oxygen therapy-related knowledge scores (all P>0.05). Conclusion Many deficiencies are observed regarding the nasal oxygen practice in ICUs of Chinese hospitals. Increased efforts by authorities and medical staff are required to narrow the gap between the current status of oxygen practice and the recommendations from related guidelines.
Collapse
Affiliation(s)
- Zunjia Wen
- SICU, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Junyu Chen
- SICU, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Lanzheng Bian
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ailing Xie
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Mingqi Peng
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Li
- Nursing Department, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Li Wei
- SICU, Children’s Hospital of Nanjing Medical University, Nanjing, China
- * E-mail:
| |
Collapse
|
4
|
Abstract
Background Common in children under two years, bronchiolitis is usually caused by respiratory syncytial virus (Jhawar 2003). Symptoms are usually self-limiting although some children develop respiratory distress requiring hospitalisation (Scottish Intercollegiate Guidelines Network 2006). Supplemental oxygen, fluid support and ventilator assistance may also be necessary. In cases of moderately severe bronchiolitis, oxygen can be delivered through a head box, but some hospitals deliver high-flow oxygen therapy with nasal prongs to treat respiratory distress.
Collapse
|
5
|
Beckford K. "Oxygen must be treated like a drug to avoid under or overdose". Nurs Times 2016; 112:11. [PMID: 27544956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
6
|
Goldman P. Emergency first aid oxygen response in schools: O2 administration in schools by nurses and lay responders. NASN Sch Nurse 2015; 30:90-94. [PMID: 25816439 DOI: 10.1177/1942602x14563802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Pete Goldman
- Lt Col ret., USAFR, Consultant for Lif-O-Gen First Aid Oxygen Div., Allied Healthcare Products Inc., St. Louis, MO
| |
Collapse
|
7
|
Galligan CJ, Markkanen PK, Fantasia LM, Gore RJ, Sama SR, Quinn MM. A growing fire hazard concern in communities: home oxygen therapy and continued smoking habits. New Solut 2015; 24:535-54. [PMID: 25816169 DOI: 10.2190/ns.24.4.g] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Safe Home Care Project investigated both qualitatively and quantitatively a range of occupational safety and health hazards, as well as injury and illness prevention practices, among home care aides in Massachusetts. This article reports on a hazard identified by aides during the study's initial focus groups: smoking by home care clients on long-term oxygen therapy. Following the qualitative phase we conducted a cross-sectional survey among 1,249 aides and found that medical oxygen was present in 9 percent of aide visits (314 of aides' 3,484 recent client visits) and that 25 percent of clients on oxygen therapy were described as smokers. Based on our findings, the Board of Health in a local town conducted a pilot study to address fire hazards related to medical oxygen. Medical oxygen combined with smoking or other sources of ignition is a serious fire and explosion hazard that threatens not only workers who visit homes but also communities.
Collapse
|
8
|
Abstract
Espite oxygen being one of the most frequently administered substances in the hospital environment, there is little empirical data regarding its use. Review of the literature regarding the clinical assessment of hypoxia and hypoxaemia reveals inconsistency in the definition of terms and raises questions as to the reliability of the clinical indicators currently used to assess the need for supplemental oxygen. Assessment of the need for supplemental oxygen and continued re-evaluation of the patient's oxygen requirements is a nursing responsibility. Physical assessment, in combination with pulse oximetry, is the most common method used by nurses to assess oxygenation status. This paper critically appraises the literature to examine the reliability of clinical indicators of oxygenation used by nurses in acute care settings.
Collapse
Affiliation(s)
- Julie Considine
- School of Nursing, Deakin University, The Northern Hospital, Epping, Victoria
| |
Collapse
|
9
|
Hanlon D. High flow nasal cannula oxygen therapy for infants and young children with bronchiolitis. Aust Nurs Midwifery J 2014; 22:28-31. [PMID: 25286711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
10
|
Lucchini A, Elli S, Bambi S, Foti G, Fumagalli R. [Invasive and non-invasive ventilation: impact on nursing workload]. Assist Inferm Ric 2014; 32:124-31. [PMID: 24158026 DOI: 10.1702/1338.14853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Non invasive ventilation (NIV) is increasingly used in intensive and non intensive wards. OBJECTIVE To detect the impact of ventilation modes on nursing workload. METHODS Retrospective observational study of 200 patients admitted to a general Intensive Care Unit (ICU). Nursing Activities Score (NAS) was used to measure the nursing workload. Patients enrolled were treated with the following ventilation modes: oxygen therapy without positive end-expiratory pressure (PEEP), helmet Continuous Positive Airway Pressure (CPAP), controlled mechanical ventilation, Invasive pressure support ventilation (I-PSV). RESULTS The overall mean NAS score of patients was 74.3% (SD ±8.88 - range 39/143) corresponding to an ideal nurse/patient ratio of 0.7 and varied with the different ventilation modes. In the days in oxygen therapy, the average NAS was 64.5% (±11.9), with helmet CPAP 69.7% (±12.7), with controlled mechanical ventilation 86.1% (SD ±15.1) and with invasive assisted ventilation 76.4% (±11.4) [p=0.0001]. In patients with helmet CPAP the NAS increased of 14% when FiO2 >0.6 and PEEP >10 compared to oxygen therapy. The average NAS score of the 15 patients (7.5%) with mask-PSV was 80.2% (±12:5). CONCLUSIONS Overall, the nursing workload of patient with helmet CPAP was lower than with invasive ventilation. In Helmet CPAP, with FiO2 >0.6 and PEEP level >10 cmH2O and mask-PSV, the nursing workload is similar to that of patients with invasive ventilation. NAS scores in patients with Invasive ventilation in the controlled mode is higher than with assisted mode.
Collapse
|
11
|
Olive S. "Why do we remain so blasé about administering oxygen"? Nurs Times 2014; 110:11. [PMID: 24834598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
12
|
Abstract
Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of failed circulatory adaptation at birth, seen in about 2/1000 live born infants. While it is mostly seen in term and near-term infants, it can be recognized in some premature infants with respiratory distress or bronchopulmonary dysplasia. Most commonly, PPHN is secondary to delayed or impaired relaxation of the pulmonary vasculature associated with diverse neonatal pulmonary pathologies, such as meconium aspiration syndrome, congenital diaphragmatic hernia, and respiratory distress syndrome. Gentle ventilation strategies, lung recruitment, inhaled nitric oxide, and surfactant therapy have improved outcome and reduced the need for extracorporeal membrane oxygenation (ECMO) in PPHN. Newer modalities of treatment discussed in this article include systemic and inhaled vasodilators like sildenafil, prostaglandin E1, prostacyclin, and endothelin antagonists. With prompt recognition/treatment and early referral to ECMO centers, the mortality rate for PPHN has significantly decreased. However, the risk of potential neurodevelopmental impairment warrants close follow-up after discharge for infants with PPHN.
Collapse
Affiliation(s)
- Jayasree Nair
- Center for Developmental Biology of the Lung, State University of New York, Buffalo, NY
| | - Satyan Lakshminrusimha
- Center for Developmental Biology of the Lung, State University of New York, Buffalo, NY; Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, 219 Bryant St, Buffalo, NY 14222.
| |
Collapse
|
13
|
Pritchard MJ. Regular observations: safe airway management. Br J Nurs 2013; 22:554. [PMID: 23752451 DOI: 10.12968/bjon.2013.22.10.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
14
|
Hürlimann B, Spichiger E, Ott S, Schild A, Leuenberger JS, Wyss D. [Ventilator weaning requires interprofessional management]. Krankenpfl Soins Infirm 2013; 106:34-35. [PMID: 24479226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Barbara Hürlimann
- Universitätsklinik fur Pneumologie, Inselspital Universitätsspital Bern.
| | | | - Sebastian Ott
- Universitätsklinik fur Pneumologie, Inselspital Universitätsspital Bern
| | - Anita Schild
- Universitätsklinik fur Pneumologie, Inselspital Universitätsspital Bern
| | | | - Daniela Wyss
- Universitätsklinik fur Pneumologie, Inselspital Universitätsspital Bern
| |
Collapse
|
15
|
Godet M. [Radial artery puncture]. Rev Infirm 2012:53-54. [PMID: 22670470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
16
|
van der Eijk AC, Dankelman J, Schutte S, Simonsz HJ, Smit BJ. An observational study to quantify manual adjustments of the inspired oxygen fraction in extremely low birth weight infants. Acta Paediatr 2012; 101:e97-104. [PMID: 22040264 DOI: 10.1111/j.1651-2227.2011.02506.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To quantify manual fraction of inspired oxygen (FiO(2)) adjustments performed by caregivers in extremely low birth weight (ELBW; ≤1000 g) infants, in relation to oxygen saturation (SpO(2)) and bedside care. METHODS In a single-centre study, FiO(2) , SpO(2) and alarm limits of ELBW infants were collected for 3 days continuously, while caregivers were filmed. A descriptive analysis, focused on manual FiO(2) adjustments, was performed. RESULTS Twelve ELWB infants were included. Total recording time was 726 h. FiO(2) was increased 851 times and decreased 1309 times; median (range) step size was 5% (1% to 65%) and -3% (-1% to -65%), respectively. Wide variation of FiO(2) adjustments for equal levels of SpO(2) was observed in all included infants. One hundred and twenty-six of 136 FiO(2) adjustments with a step size ≥15% and 111 of 171 desaturations <70% were associated with medical or nursing procedures. When FiO(2) was >21%, alarm limits for SpO(2) were set according to protocol (88-94%) in 64% of the time. Within these periods, SpO(2) was >94% for 30% and <88% for 16% of the time. CONCLUSIONS Manual FiO(2) adjustments varied widely in frequency and step size. Deep desaturations and large FiO(2) adjustments were associated with medical or nursing procedures. When large adjustments are really necessary, it will be challenging to implement them in an automatic adjustment device.
Collapse
Affiliation(s)
- Anne Catherine van der Eijk
- Department of BioMechanical Engineering, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, The Netherlands.
| | | | | | | | | |
Collapse
|
17
|
From S, Lewandowski K, Pacholska-Pytlakowska M. [Recent indications for home oxygen therapy]. Pol Merkur Lekarski 2011; 31:368-371. [PMID: 22239009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Home oxygen therapy is a treating method with an effect on improving the life comfort and long of life in the group of patients suffered from non-neoplasmic lung diseases complicated by partial respiratory failure, proved in many clinical trials according to some estimations the number of patients in Poland who fulfill home oxygen therapy qualification's criteria is twice higher then the number of patients who benefit from this method of therapy. This situation should make pneumonologists concern with problems of patients suffered from the respiratory failure who need this kind of therapy.
Collapse
Affiliation(s)
- Sławomir From
- Wojskowy Instytut Medyczny w Warszawie, Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii CSK MON.
| | | | | |
Collapse
|
18
|
Duncan P, Okosi O. Reviewing home oxygen services. Nurs Times 2011; 107:24-25. [PMID: 22187826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Home oxygen therapy costs millions of pounds every year and demand for the service is growing. As part of the Department of Health's respiratory programme, NHS Improvement--Lung works with several clinical teams in England to address variations in patient care. This article discusses how oxygen service assessment and review can save money and raise the quality of care.
Collapse
|
19
|
Turjanica MA, Clark L, Martini C, Miller P, Turner BL, Jones S. Incidence, correlates, and interventions used for pressure ulcers of the ear. Medsurg Nurs 2011; 20:241-247. [PMID: 22165783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Skin prevalence audits revealed annual increases in incidence of pressure ulcers of the ear. A research study was conducted to assess correlates of the problem. Study results guided clinical practice changes that reduced the incidence to zero.
Collapse
|
20
|
Cottrell RG. Clearing up COPD questions. Nursing 2011; 41:8; author reply 8. [PMID: 21739678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
21
|
Tigreat J. [Oxygen therapy]. Rev Infirm 2011:43-44. [PMID: 21341451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
22
|
Veyssière C, Bonnard J, Pivert L, Freymond N, Pacheco Y. [Complemental nurses in a health service for patients with chronic obstructive lung disease]. Rev Infirm 2011:34-36. [PMID: 21319425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
23
|
Luettel D. Making oxygen use safer in hospitals. Nurs Times 2010; 106:10-11. [PMID: 20514881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
24
|
Jevon P. How to ensure patient observations lead to prompt identification of tachypnoea. Nurs Times 2010; 106:12-14. [PMID: 20218442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Tachypnoea is one of the first signs of patient deterioration and accurate measurement of respiratory rate is a fundamental part of assessment. This article aims to describe the assessment and management of tachypnoea.
Collapse
|
25
|
Duck A. Principles to effectively manage people with interstitial lung disease in the community. Nurs Times 2009; 105:29-30. [PMID: 20169853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This article examines the problems of caring for people with interstitial lung disease in primary care. It describes simple strategies that can support people to remain at home during the end stage of their illness. The diagnosis and investigations of ILD have been covered in previous Nursing Times articles (Duck, 2007a; 2007b).
Collapse
Affiliation(s)
- Annette Duck
- University Hospital of South Manchester Foundation Trust
| |
Collapse
|
26
|
Farges E, Rautureau P. [Evaluation and treatment of dyspnea and palliative care]. Rev Infirm 2009:33-35. [PMID: 19947289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
27
|
Pritchard MJ. Airway management of an elective surgical patient. Br J Nurs 2009; 18:1160-1165. [PMID: 19966739 DOI: 10.12968/bjon.2009.18.19.44819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Airway management is a skill that all healthcare professionals need to learn. This skill is used in two specific areas. First, in emergency situations such as cardiac arrest or respiratory arrest. Second, and the subject of this article, the postanaesthetic patient. This article explores not only the anatomy of the respiratory system but the different techniques and methods employed to manage a patient's airway. Airway management can be divided into three distinct phases. The first phase deals with the management of the airway while the patient undergoes an operation; this is managed by the anaesthetist. While the second phase deals with the patient's airway in the immediate recovery period, it usually occurs in a recover room and is managed by a recovery nurse. The third phase is when the patient returns to the ward, and for the first 24-48 hours after a general anaesthetic. It is only by recognizing the signs and symptoms of respiratory distress and initiating effective treatment that serious consequences can be avoided.
Collapse
|
28
|
Armstrong B, Reid C, Heath P, Simpson H, Kitching J, Nicholas J, Chan L, Taylor J, Rush H. Rapid sequence induction anaesthesia: a guide for nurses in the emergency department. Int Emerg Nurs 2009; 17:161-8. [PMID: 19577203 DOI: 10.1016/j.ienj.2008.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 11/01/2008] [Accepted: 11/24/2008] [Indexed: 11/17/2022]
Abstract
Emergency rapid sequence induction (RSI) anaesthesia is the cornerstone of emergency airway management performed on patients in the emergency department (ED). The Royal College of Anaesthetists has stated that anaesthesia should not proceed without a skilled, dedicated assistant. It is essential that ED nurses are educated, skilled and competent to assist with RSI in the ED.
Collapse
Affiliation(s)
- Bruce Armstrong
- Department of Emergency Medicine, Basingstoke and North Hampshire Hospital Trust, Aldermaston Road, Basingstoke RG24 9NA, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
|
30
|
Smith SMS, Roberts SB, Duggan-Brennan M, Powrie KE, Haffenden R. Emergency oxygen delivery in adults 1: updating nursing practice. Nurs Times 2009; 105:16-18. [PMID: 19400337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The first in this two-part unit discusses new British Thoracic Society guidance on using emergency oxygen in adults. This is the first national guidance on this area and the implications for possible changes to practice are highlighted here. This part outlines the philosophy behind the guideline, the differences between hypoxaemic and hypercapnic patients and essential assessments for critically ill patients who need emergency oxygen. It also discusses using this therapy for patients with lung cancer in acute situations.
Collapse
Affiliation(s)
- Sheree M S Smith
- St Mary's Hospital, London, Imperial College Healthcare NHS Trust
| | | | | | | | | |
Collapse
|
31
|
Duck A. Does oxygen need to be prescribed? Nurs Times 2009; 105:19. [PMID: 19400338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Annette Duck
- Association of Respiratory Nurse Specialists, University Hospital of South Manchester, Manchester
| |
Collapse
|
32
|
Morris K. I was told that only a registered nurse may transfer the patient from portable to wall O2 in my setting. Ohio Nurses Rev 2009; 84:10. [PMID: 19248430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
33
|
Is there a regulation, etc. for medical oxygen administration? AAOHN J 2009; 57:7-8. [PMID: 19248743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
34
|
Nasiłowski J, Przybyłowski T, Klimiuk J, Leśkow A, Orska K, Chazan R. [Effects of nurse home visits on compliance to long-term oxygen therapy. 14 months follow-up]. Pneumonol Alergol Pol 2009; 77:363-370. [PMID: 19722141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Long-term oxygen therapy (LTOT) is the only treatment improving survival of patients with respiratory failure due to chronic obstructive pulmonary disease (COPD). Benefits of treatment depend mainly on daily duration of oxygen use. The aim of the study was to assess daily use of oxygen and to evaluate influencing factors. MATERIAL AND METHODS Consecutive patients qualified to LTOT were included. Eligibility for LTOT was based on the ATS//ERS guidelines. All patients were instructed to use oxygen from oxygen concentrator for 15 hours per day or more. Duration of oxygen therapy was verified every 4 weeks by visiting respiratory nurse using counter clock of oxygen concentrator. The nurses were also encouraging patients to breathe oxygen for at least 15 h/d. RESULTS Study group consisted of 30 patients (77% with COPD) aged 67+/-9 yrs, mean FEV, 46+/-18% pred., RV%TLC 64+/-16%, PaO2 50+/-6 mm Hg. Mean duration of oxygen therapy for the group was 12.5+/-4.6 h/d. Eleven (37%) subjects followed prescription during whole follow-up period (mean oxygen use 17.4+/-2.6 h/d). Mean oxygen use in the non-compliant group was 9.6+/-2.7 h/d. In COPD group compliant patients had significantly lower TLC (100+/-19% pred. v. 152+/-36% pred., p=0.001) and lower PaCO2 (38+/-6 mm Hg v. 47+/-8 mm Hg, p<0.05) when compared to the non-compliant group. During the first month of treatment 48% of patients were compliant. From the second month onward percentage of compliant patients fell to 30% and remained stable to the end of the study. Fourteen patients (47% complained of electricity consumption and 7 patients (23%) complained of the noise of working concentrator. Daily oxygen use in the latest group was significantly lower when compared to those who did not complain of the noise (9+/-3.7 h/d v. 13.5+/-4.4 h/d; p=0.02). CONCLUSIONS The best compliance to home oxygen therapy is observed at the beginning of treatment. Frequent home nurse visits do not improve compliance. We hypothesize that the use of other oxygen sources eg. liquid oxygen, that are silent and do not increase the cost of electricity, could improve compliance.
Collapse
Affiliation(s)
- Jacek Nasiłowski
- Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii Warszawskiego Universytetu Medycznego, Warszawa.
| | | | | | | | | | | |
Collapse
|
35
|
Rose L, Redl L. Minimal occlusive volume cuff inflation: a survey of current practice. Intensive Crit Care Nurs 2008; 24:359-65. [PMID: 18595709 DOI: 10.1016/j.iccn.2008.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2008] [Revised: 04/30/2008] [Accepted: 05/14/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the minimal occlusive volume (MOV) procedure used to monitor cuff inflation and identify practice variation. RESEARCH METHODOLOGY Self-administered questionnaire. SETTING Adult intensive care unit in an Australian university-affiliated hospital. RESULTS Survey response was 71% (80/113). Three methods of MOV were identified. Full cuff deflation, followed by reinflation, removal of 1mL increments of air until a leak was detected, then restoration of cuff seal with 1mL of air was the preferred method (47/80 respondents, 59%) (Method 1). Full cuff deflation followed by incremental addition of air until the MOV was established was used by 25/80 (31%) respondents (Method 2). Two (2.5%) nurses established MOV without full cuff deflation (Method 3), five (6.25%) used more than one method and one (1.25%) nurse did not perform cuff checks. Practice variation was identified for patient positioning, confirmation of cuff seal, and cuff leak management. Consistency of practice was noted in MOV procedure frequency, the number of nurses required, pre-oxygenation and oropharyngeal suctioning prior to cuff deflation. CONCLUSION Substantial practice variation for certain aspects of cuff management was noted. Evidence to support the efficacy of MOV procedural elements is required to limit practice variation and reduce risk to patients.
Collapse
MESH Headings
- Attitude of Health Personnel
- Benchmarking
- Critical Care/methods
- Equipment Design
- Equipment Failure
- Evidence-Based Nursing
- Health Knowledge, Attitudes, Practice
- Hospitals, University
- Humans
- Insufflation/adverse effects
- Insufflation/methods
- Insufflation/nursing
- Intubation, Intratracheal/adverse effects
- Intubation, Intratracheal/instrumentation
- Intubation, Intratracheal/nursing
- Monitoring, Physiologic/methods
- Monitoring, Physiologic/nursing
- Nurse's Role
- Nursing Evaluation Research
- Nursing Staff, Hospital/education
- Nursing Staff, Hospital/psychology
- Oxygen Inhalation Therapy/methods
- Oxygen Inhalation Therapy/nursing
- Pneumonia, Aspiration/etiology
- Pneumonia, Aspiration/prevention & control
- Posture
- Practice Guidelines as Topic
- Suction/methods
- Suction/nursing
- Surveys and Questionnaires
- Victoria
Collapse
Affiliation(s)
- Louise Rose
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Room 276, Toronto, ON M5T1P8, Canada.
| | | |
Collapse
|
36
|
Kelly C, Lynes D. The use of domiciliary oxygen therapy. Nurs Times 2008; 104:46-48. [PMID: 18605350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Carol Kelly and Dave Lynes discuss the evidence and assessment for domiciliary oxygen, as well as considering oxygen therapy in palliative care.
Collapse
Affiliation(s)
- Carol Kelly
- Edge Hill University/Respiratory Education UK
| | | |
Collapse
|
37
|
Gegel BT. A field-expedient Ohmeda Universal Portable Anesthesia Complete draw-over vaporizer setup. AANA J 2008; 76:185-187. [PMID: 18567321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The Ohmeda Universal Portable Anesthesia Complete (U-PAC) draw-over anesthetic system is active in the US Army inventory. It is standard equipment for Certified Registered Nurse Anesthetists assigned to US Army Forward Surgical Teams and Joint Special Operations Command. The purpose of this article is to describe a practical and field-expedient U-PAC draw-over vaporizer setup used during Operation Iraqi Freedom I (February 2003 to July 2003). During the deployment, general anesthesia was administered to 25 patients with penetrating trauma using the Gegel-Mercado setup without system malfunction. This setup strengthens the standard U-PAC draw-over system delivery because it increases fractional inspired oxygen concentrations, promotes hands-free operation, enhances circuit cleanliness reducing cross contamination, and provides an alternate method for draw-over anesthesia administration in austere conditions when a ventilator may not be available or practical. It integrates and builds on the core concepts of draw-over anesthesia delivery in the literature. The Gegel-Mercado setup is combat proven.
Collapse
Affiliation(s)
- Brian T Gegel
- United States Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, Texas, USA.
| |
Collapse
|
38
|
Watson D. Pneumonia 2: effective nursing assessment and management. Nurs Times 2008; 104:30-31. [PMID: 18323383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Part 1 of this two-part unit on pneumonia explored common signs and symptoms of the infection, and explained how nurses can identify those at high risk. This part looks at its nursing assessment and management.
Collapse
|
39
|
Biddle C. Oxygen: the two-faced elixir of life. AANA J 2008; 76:61-68. [PMID: 18323322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Take a moment and consider our planet without oxygen. Imagine the earth some 2.5 billion years ago when oxygen first appeared as a waste product of early anaerobes. Oxygen, as we know it today, is essential for life. Abundant and relatively inexpensive to manufacture, oxygen has widespread use in industry and healthcare. Anesthesia providers routinely administer oxygen in concentrations exceeding that in ambient air to ensure clinical safety and to offset the predictable sequelae associated with patient, drug-related, and procedural factors. Understanding the history of this unique element is critical in evaluating the often contentious body of contemporary research that has illuminated its efficacy (as elixir) and its attendant complications (its "two-faced" nature). Of particular interest is its role in free radical formation as etiogenic in developing complications. Oxygen is a mainstay in the perioperative management of patients, but its administration should be guided by thoughtful and rational goal-directed outcomes to maximize efficacy and minimize complications associated with its use.
Collapse
Affiliation(s)
- Chuck Biddle
- Virginia Commonwealth University, Richmond, USA.
| |
Collapse
|
40
|
Jevon P. Severe allergic reaction: management of anaphylaxis in hospital. Br J Nurs 2008; 17:104-108. [PMID: 18414282 DOI: 10.12968/bjon.2008.17.2.28137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Anaphylaxis is an acute, severe, hypersensitivity reaction that can lead to asphyxia, cardiovascular collapse and cardiac arrest. This reaction is sudden, severe, and involves the whole body. Common causes include foods such as nuts, shellfish, dairy products and eggs. Non-food causes include bee/wasp stings, latex and drugs, e.g. penicillin. Common clinical features include urticaria, angioedema, respiratory distress and shock. Summoning expert help, reclining the patient flat, administering high concentration oxygen, and administering intramuscular adrenaline are key aspects of the nursing management of anaphylaxis in hospital. The aim of this article is to understand the management of anaphylaxis in hospital, with particular reference to national consensus guidelines.
Collapse
Affiliation(s)
- Phil Jevon
- Learning Department, Manor Hospital,Walsall
| |
Collapse
|
41
|
Kela N. [Problems in general practice--solutions for general practice: air to live]. Pflege Z 2008; 61:12-15. [PMID: 18251189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
|
42
|
Kelly C, Riches A. Emergency oxygen for respiratory patients. Nurs Times 2007; 103:40-42. [PMID: 18038825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Oxygen is prescribed for hypoxaemic patients to increase alveolar oxygen tension and decrease the effort of breathing. Although principally life saving, in certain circumstances it can be lethal if prescribed and/or administered incorrectly. To ensure safe, effective delivery of oxygen, health professionals dealing with the administration, titration and monitoring of oxygen therapy should understand the principles that underpin its use. Carol Kelly and Anne Riches discuss administering oxygen therapy in the acute situation.
Collapse
Affiliation(s)
- Carol Kelly
- Edge Hill University/Respiratory Education UK
| | | |
Collapse
|
43
|
Abstract
Respiratory disorders are among the most common reasons for admission to critical care units in the U.K. However, anecdotal evidence suggests that nursing assessment of patients' respiratory function is not performed well because it is not considered a priority and the implications of respiratory dysfunction are underestimated. It is essential that nurses are able to recognise and assess symptoms. of respiratory dysfunction to provide early, effective and appropriate interventions, thus improving patient outcomes. This article highlights the role of the nurse in respiratory assessment and discusses the implications of clinical findings.
Collapse
Affiliation(s)
- T Moore
- School of Health and Social Sciences, Middlesex University, Middlesex.
| |
Collapse
|
44
|
Eastwood G, Gardner A, O'Connell B. Low-flow oxygen therapy: selecting the right device. Aust Nurs J 2007; 15:27-30. [PMID: 17969390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Glenn Eastwood
- School of Nursing, Deakin University, Epworth Eastern Hospital, Victoria, Australia [corrected]
| | | | | |
Collapse
|
45
|
Considine J, Botti M, Thomas S. The effect of education on hypothetical and actual oxygen administration decisions. Nurse Educ Today 2007; 27:651-60. [PMID: 17118496 DOI: 10.1016/j.nedt.2006.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Revised: 08/15/2006] [Accepted: 10/10/2006] [Indexed: 05/12/2023]
Abstract
AIM This study examined the effect of an education intervention on emergency nurses' decisions related to oxygen administration. METHOD A controlled pre-test/post-test quasi-experimental design was used. The intervention was a written self directed learning package. Outcome measures were (i) factual knowledge measured using parallel form multiple choice questions (MCQs) and (ii) clinical decisions measured using parallel form MCQs, parallel form patient scenarios and clinical practice observation. RESULTS Eighty-eight nurses from 4 Melbourne EDs participated in the study (control group: n=37 and experimental group: n=51). Subgroups of nurses from the experimental group also participated in the patient scenarios (n=20) and clinical practice observation (n=10). Emergency nurses' knowledge increased as a function of education. Both patient scenario data and clinical practice observation showed decreased selection of nasal cannulae, increased selection of air entrainment masks and a trend towards selection of higher oxygen flow rates following education. CONCLUSIONS Evaluation of educational interventions in nursing should focus on identifying strategies that enhance learning in a clinical environment, are valid in terms of the clinical context and culture in which they are being used and most importantly, produce sustained improvements in actual clinical practice.
Collapse
Affiliation(s)
- Julie Considine
- School of Nursing, Faculty of Health and Behavioural Sciences, Deakin University, 221 Burwood Highway, Burwood, 3125 Vic., Australia.
| | | | | |
Collapse
|
46
|
Abstract
Dyspnea is a common symptom in patients with acute and chronic critical illness as well as in patients receiving palliative care. While dyspnea can be found in a variety of clinical arenas and across many specialties, the mechanisms that cause dyspnea are similar. Although not often the cause for admission to critical care, it may complicate and extend length of stay. This article defines and describes dyspnea and its pathophysiology. Critical care nurses should strive to implement interventions supported by evidence whenever possible. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with dyspnea is outlined, using levels of recommendation based on the strength of available evidence. Two case studies are presented to illustrate its application to clinical practice.
Collapse
Affiliation(s)
- Nancy Spector
- National Council of State Boards of Nursing, 111 E Wacker, Suite 2900, Chicago, IL 60601, USA.
| | | | | |
Collapse
|
47
|
Abstract
Although respiratory disease can occur at any age, older people are more likely to suffer both acute and chronic respiratory disease. Without sufficient oxygen, cells fail and die, and extensive cell death causes body systems to fail. This article considers the principles of short-term oxygen therapy and offers guidance to nurses who may be required to administer such treatment in their work with older people.
Collapse
|
48
|
Clancy K. Experiences of a novice researcher. Nurse Res 2007; 14:27-38. [PMID: 17702141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Karen Clancy, a nurse consultant but a novice researcher reflects on her study of patients with respiratory disease living at home with long-term oxygen therapy. She explores the dual role of researcher and clinician, and concludes with suggestions designed to help other novice researchers.
Collapse
|
49
|
Abstract
An audit of oxygen administration to children in the paediatric unit of a district general hospital was carried out following the introduction of new guidelines. The aim of the audit was to review oxygen administration practices against the guidance but also to gather information concerning patients, diagnoses, prescription practices and delivery devices. The notes of 36 infants and children admitted during a two week (winter) period who received oxygen were retrospectively reviewed for the audit. The standards for monitoring the amount of oxygen delivered and oxygenation were found to be high but the prescribing of oxygen was varied. The most common diagnosis of children receiving oxygen was bronchiolitis, and the device used to deliver oxygen most frequently was nasal cannula. Few headboxes were used and experienced team members noted this as a marked change in practice. A further examination of the evidence on the use of nasal cannulae for oxygen delivery in the younger age group led to new practice recommendations.
Collapse
|
50
|
Beattie S. Back to basics with O2 therapy. RN 2006; 69:37-40. [PMID: 17017321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
|