Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for...

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Autores principales:	Sakinah Awang, Norlidah Alias, Dorothy DeWitt, Khairul Azhar Jamaludin, Mohd Nazri Abdul Rahman
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	structured advanced nursing training mechanical ventilation nurse-led ventilator-weaning protocol clinical practice guideline Fuzzy Delphi Method Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4bb4732345a0477b84e030f5f15c8ce5
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spelling	oai:doaj.org-article:4bb4732345a0477b84e030f5f15c8ce52021-11-12T05:00:54ZDesign of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training2296-256510.3389/fpubh.2021.726647https://doaj.org/article/4bb4732345a0477b84e030f5f15c8ce52021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.726647/fullhttps://doaj.org/toc/2296-2565Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.Sakinah AwangNorlidah AliasDorothy DeWittKhairul Azhar JamaludinMohd Nazri Abdul RahmanFrontiers Media S.A.articlestructured advanced nursing trainingmechanical ventilationnurse-led ventilator-weaning protocolclinical practice guidelineFuzzy Delphi MethodPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	structured advanced nursing training mechanical ventilation nurse-led ventilator-weaning protocol clinical practice guideline Fuzzy Delphi Method Public aspects of medicine RA1-1270
spellingShingle	structured advanced nursing training mechanical ventilation nurse-led ventilator-weaning protocol clinical practice guideline Fuzzy Delphi Method Public aspects of medicine RA1-1270 Sakinah Awang Norlidah Alias Dorothy DeWitt Khairul Azhar Jamaludin Mohd Nazri Abdul Rahman Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
description	Cardiothoracic intensive care unit (CICU) nurses have shared the role and responsibility for ventilator-weaning to expedite decision-making in patient care. However, the actions taken are based on individual's unstructured training experience as there is no clinical practice guideline (CPG) for nurses in Malaysia. Hence, this study aims to design a CPG for the process of weaning from mechanical ventilation (MV) for a structured nursing training in a CICU at the National Heart Institute (Institut Jantung Negara, IJN) Malaysia. The Fuzzy Delphi Method (FDM) was employed to seek consensus among a panel of 30 experts in cardiac clinical practice on the guidelines. First, five experts were interviewed and their responses were transcribed and analyzed to develop the items for a FDM questionnaire. The questionnaire, comprising of 73 items, was distributed to the panel and their responses were analyzed for consensus on the design of the CPG. The findings suggested that the requirements expected for the nurses include: (a) the ability to interpret arterial blood gases, (b) knowledge and skills on the basics of mechanical ventilation, and (c) having a minimum 1-year working experience in the ICU. On the other hand, the CPG should mainly focus on developing an ability to identify criteria of patient eligible for weaning from MV. The learning content should focus on: (a) developing the understanding and reasoning for weaning and extubating and (b) technique/algorithm for extubating and weaning. Also, the experts agreed that the log book/competency book should be used for evaluation of the program. The CPG for structured nursing training at IJN in the context of the study is important for developing the professionalism of CICU nurses in IJN and could be used for training nurses in other CICUs, so that decision for ventilator-weaning from postcardiac surgery could be expedited.
format	article
author	Sakinah Awang Norlidah Alias Dorothy DeWitt Khairul Azhar Jamaludin Mohd Nazri Abdul Rahman
author_facet	Sakinah Awang Norlidah Alias Dorothy DeWitt Khairul Azhar Jamaludin Mohd Nazri Abdul Rahman
author_sort	Sakinah Awang
title	Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
title_short	Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
title_full	Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
title_fullStr	Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
title_full_unstemmed	Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training
title_sort	design of a clinical practice guideline in nurse-led ventilator-weaning for nursing training
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/4bb4732345a0477b84e030f5f15c8ce5
work_keys_str_mv	AT sakinahawang designofaclinicalpracticeguidelineinnurseledventilatorweaningfornursingtraining AT norlidahalias designofaclinicalpracticeguidelineinnurseledventilatorweaningfornursingtraining AT dorothydewitt designofaclinicalpracticeguidelineinnurseledventilatorweaningfornursingtraining AT khairulazharjamaludin designofaclinicalpracticeguidelineinnurseledventilatorweaningfornursingtraining AT mohdnazriabdulrahman designofaclinicalpracticeguidelineinnurseledventilatorweaningfornursingtraining
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Design of a Clinical Practice Guideline in Nurse-Led Ventilator-Weaning for Nursing Training

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