A systematic review : nursing practice and respiratory muscle function in adult ventilated patients

Abstract

Mechanical ventilation is a frequently used intervention in Intensive Care Units to support respiratory function during critical illness. Nurses are responsible for the 24-hour care associated with this intervention. Respiratory muscle function has been identified as a factor that impacts a patient’s ability to resume normal breathing after a period OD mechanical ventilation. Nursing interventions directed toward preserving, maintaining or rehabilitating respiratory muscle function are important because such interventions could greatly improve a patient’s recovery from critical illness. This research project has systematically reviewed the literature regarding how respiratory muscles change during mechanical ventilation. The aim has been to identify how the current level of research can inform practice for nurses regarding respiratory muscle function during mechanical ventilation. This has been achieved through critical analysis and synthesis OD current research, which enabled identification OD nursing interventions to facilitate optimum function of respiratory muscles in ventilated patients. Best practice for nurses in regard to respiratory muscle function is to participate in a multidisciplinary team which strives to provide an individualised, holistic plan of care. The plan should be based on the premise that respiratory muscle function is a complex, multidimensional phenomenon which impacts on weaning from mechanical ventilation. Furthermore, this plan of care would recognize weaning as a nonlinear continuum which has peaks and troughs as well as advances and regression. In order to claim best practice, a plan of care for respiratory muscle function would include: a clearly communicated training regime for inspiratory and expiratory muscles, strategies to reduce stress, anxiety and dyspnea as well as standardized documentation for sputum, and cough assessment. Implementation of best practice for respiratory muscle function would include early nutrition, minimal use of sedation, and maximum opportunity for whole body skeletal muscle tone. It is anticipated that implementation of these findings would lead to improved nursing care of patients who receive mechanical ventilation during periods of critical illness.

Date of Award	2006
Original language	English