Impacts of Nurse - Coursework Example

Depending on institutional protocols and policies, critical care units are highly vigilant about weaning these patients from ventilators as soon as they are able to breathe on their own. To be able to do early weaning, the critical care physicians usually take lead roles in decision making, where weaning from ventilation takes place in a non-protocolized fashion. However, studies have also shown that non-physician healthcare professionals such as nurses may also play important roles where a protocol is provided to them.

  In this literature review impacts of nurse-administered protocolized weaning from ventilation have been reviewed from the current literature. Mechanical ventilation is commonly used in the intensive care setting to artificially ventilate persons who are unable to breathe spontaneously at all or are unable to provide themselves with adequate spontaneous ventilation to guarantee satisfactory gas exchange (Boles et al., 2007, 1033-1056). Patients in an intensive care setting often require a longer period of ventilation than in other settings.

  Intensive care nurses play important roles in maintaining these patients on ventilators since ventilator-dependent patients need to be monitored continuously for different parameters. Other than monitoring the ventilator-dependent patients, despite ventilation being a life-saving measure, the nurses also need to know how fast the patients can be weaned from the ventilator. It is thus imperative for the intensive care nurses to have a thorough understanding of the principles and mechanics of mechanical ventilation in order to ensure that these patients are monitored on, maintained in, and weaned from the ventilator (Walsh, Dodds, and McArdle, 2004, 793-799).

  ProtocolsProtocols for weaning are specific and explicit instructions that can be followed by nurses and other healthcare professionals. ICU protocols for mechanical ventilation are specific for a population of patients and for a certain hospital or institution. For example, a weaning protocol may work well in a multipurpose ICU and not so well in a cardiovascular recovery room. As indicated by Horst et al. (1998) the weaning protocols must have a high level of consensus because they limit the independence of the physician and nurses to decide by themselves.

  Frequently, since they are specific to procedures, they can form part of several flow charts (Horst et al., 1998, 483-489).Theme 1: Role of nurses in the weaning process nurses play important roles in the care of these patients in any care setting. In critically ill adult patients, every institute has a protocol that needs to be followed in the intensive care unit. Knebel (1996) recognized that nurses have perhaps the most important role in the execution of the process of weaning, whether it is protocolized or non-protocolized.

  A wrong decision to wean may increase the morbidity and mortality of these adults leading to an extended hospital stay since both early and late weaning have their own risks and benefits (Knebel, 1996, 550-559). Ramachandran et al. (2005) suggested that if a standard protocol is used, all the nurses would attempt to fulfill the requirements for an acceptable standard where weaning is indicated, irrespective of their experiences in weaning.