Nurse's Practices for Patients Undergoing Respiratory Ventilator in the Intensive Care Unit

Abstract

Background: Mechanical ventilation can partially or fully replace spontaneous breathing. Its main purpose is to improved gas exchange and decreased work of breathing by delivering preset concentrations of oxygen at an adequate tidal volume. An artificial airway (endotracheal tube) or tracheostomy is needed to a patient requiring mechanical ventilation, the roles of the nurses in the respiratory care unit are vital in assessing and monitoring the response of these patients to ventilation, and intervene to maintain oxygenation and ventilation. Aim of this study: The study aims to assess the nurse's practices for patients undergoing respiratory ventilator in the intensive care unit, and to find out the relationship between the nurses’ practices and socio - demographic characteristics which as the gender, level of education, years of experiences, and training course. Methodology: A descriptive study has been carried out to nurse's practices for patients undergoing respiratory ventilator in the intensive care unit at Al-Diwaniyah teaching hospital for the period from April 20th, 2021, to October 14th, 2021. Nonprobability (purposive) sample of (40) nurses who work in intensive care unit at Al-Diwaniyah teaching hospital. The sample has been collected by using assessment instrument which consists of two parts: part I: demographical characteristics of the nurse which consist of 7 items. Part II: observational checklist for the nurses in the intensive care unit which consists of 20 items. The researcher used the appropriate statistical methods in the data analysis, which included descriptive data analysis and inferential data analysis. The analyzed data have been conducted through application of descriptive statistics (Frequencies, Percentages, Mean of Scores and Standard deviation). Also, inferential statistics (Chi-Square test for testing the independency distribution of the observed frequencies); In addition, the comparison significant for this study the significant P-value ≤ 0.05. Results: Results of the study shows the nurses practices in the intensive care unit, the highest of nurses’ practices items are (sometimes). While (never) was the main nurses’ practices regarding use the appropriate size of the face mask, change the oxygen mask for each patient and use clean suction technique and shows that 51% of nurses' practices have sometimes, while 22% of them have never and 27% of them have Always concerning to overall assessment of nurses’ practices. Also, there is a significant association between overall assessment of nurses’ practices and some variables in demographic data of the study sample, at P. value <0.05. In regard to education level of the sample, it shows that there is a highly significant association at P-value (0.001); also, there are a significant association at P-value (0.03) regarding training courses about intensive care unit, and there are highly significant associations at P-value (0.001) regarding duration of training courses. Conclusions: The study concluded that the majority of nurses in intensive care unit wear sterile personal protective equipment and provide patient’s privacy by covering the patient, while high percentage of nurses does not use the appropriate size of the face mask, change the oxygen mask for each patient and does not use clean suction technique. Also, there are a highly relationship between education level, and duration of training courses about intensive care unit of the nurses in the sample and their efficiency in nursing practice. Recommendations: The study recommended engaging intensive care nurses in special training course (inside and outside of Iraq) to improve knowledge and practice regarding mechanical ventilation, and nursing staff in the intensive care unit, must include those nurses who have bachelor’s degree in nursing only. Also, health directorate should provide poster fixed on intensive care unit walls including responsibilities and duties of nurses in this unit and supply the hospitals with enough equipment and facilities used in intensive care unit.