TY - JOUR
T1 - Guideline implementation powered by feedback and education improves manual hyperinflation performance
AU - Paulus, Frederique
AU - Binnekade, Jan M.
AU - Middelhoek, Pauline
AU - Vroom, Margreeth B.
AU - Schuitz, Marcus J.
PY - 2016
Y1 - 2016
N2 - Aim: To determine whether a literature-based guideline, powered by educational meetings and individual feedback, improves manual hyperinflation (MH) performance by intensive care unit (ICU) nurses. Background: MH is frequently applied in intubated and mechanically ventilated ICU patients. MH is a complex intervention, and large variation in its performance has been found. Materials and methods: First, a literature-based guideline on MH was developed. The intervention consisted of education of this guideline and individual feedback. Before and 3 months after the intervention, ICU nurses performed MH maneuvers in a skills laboratory. Data collected included applied volumes, peak inspiratory flows (PIF) and peak expiratory flows (PEF), and the use of inspiratory holds. Results: Eighty nurses participated. Decrease of PIF was not statistically significant. PEF increased from 52 +/- 7 to 83 +/- 23 L/min (P <0.01). PIF to PEF ratio decreased from 1.4 [1.1-1.7] to 0.8 [0.6-1.1] (P <0.01). Peak inspiratory pressures decreased from 40 +/- 14 to 19 +/- 6 cm H2O (P <0.01). The proportion of nurses applying inspiratory holds increased from 14% to 58%; use of rapid release of the resuscitation bag, considered mandatory, increased from 4% to 61%. Conclusion: Implementation of a literature-based guideline on MH, powered by educational meetings and individual feedback, improves MH performance by ICU nurses. Relevance to clinical practice: If it is decided to practice MH in the care of the intubated and mechanical ventilated patient, a standardized, uniform performed MH procedure is a prerequisite
AB - Aim: To determine whether a literature-based guideline, powered by educational meetings and individual feedback, improves manual hyperinflation (MH) performance by intensive care unit (ICU) nurses. Background: MH is frequently applied in intubated and mechanically ventilated ICU patients. MH is a complex intervention, and large variation in its performance has been found. Materials and methods: First, a literature-based guideline on MH was developed. The intervention consisted of education of this guideline and individual feedback. Before and 3 months after the intervention, ICU nurses performed MH maneuvers in a skills laboratory. Data collected included applied volumes, peak inspiratory flows (PIF) and peak expiratory flows (PEF), and the use of inspiratory holds. Results: Eighty nurses participated. Decrease of PIF was not statistically significant. PEF increased from 52 +/- 7 to 83 +/- 23 L/min (P <0.01). PIF to PEF ratio decreased from 1.4 [1.1-1.7] to 0.8 [0.6-1.1] (P <0.01). Peak inspiratory pressures decreased from 40 +/- 14 to 19 +/- 6 cm H2O (P <0.01). The proportion of nurses applying inspiratory holds increased from 14% to 58%; use of rapid release of the resuscitation bag, considered mandatory, increased from 4% to 61%. Conclusion: Implementation of a literature-based guideline on MH, powered by educational meetings and individual feedback, improves MH performance by ICU nurses. Relevance to clinical practice: If it is decided to practice MH in the care of the intubated and mechanical ventilated patient, a standardized, uniform performed MH procedure is a prerequisite
U2 - https://doi.org/10.1111/nicc.12068
DO - https://doi.org/10.1111/nicc.12068
M3 - Article
C2 - 24801958
SN - 1362-1017
VL - 21
SP - 36
EP - 43
JO - Nursing in critical care
JF - Nursing in critical care
IS - 1
ER -