Bronagh Blackwood1, Jenifer Wilson-Barnett. 1. Nursing and Midwifery Research Unit, School of Nursing and Midwifery, Queen's University Belfast, 21 Stranmillis Road, Belfast, BT9 5AF N. Ireland. b.blackwood@qub.ac.uk
Abstract
BACKGROUND: Internationally, nurse-directed protocolised-weaning has been evaluated by measuring its impact on patient outcomes. The impact on nurses' views and perceptions has been largely ignored. AIM: To determine the change in intensive care nurses' perceptions, satisfaction, knowledge and attitudes following the introduction of nurse-directed weaning. Additionally, views were obtained on how useful protocolised-weaning was to practice. METHODS: The sample comprised nurses working in general intensive care units in three university-affiliated hospitals. Nurse-directed protocolised-weaning was implemented in one unit (intervention group); two ICUs continued with usual doctor-led practice (control group). Nurses' perceptions, satisfaction, knowledge and attitudes were measured by self-completed questionnaires before (Phase I) and after the implementation of nurse-directed weaning (Phase II) in all units. RESULTS:Response rates were 79% (n=140) for Phase 1 and 62% (n=132) for Phase II. Regression-based analyses showed that changes from Phase I to Phase II were not significantly different between the intervention and control groups. Sixty-nine nurses responded to both Phase I and II questionnaires. In the intervention group, these nurses scored their mean perceived level of knowledge higher in Phase II (6.39 vs 7.17, p=0.01). In the control group, role perception (4.41 vs 4.22, p=0.01) was lower and, perceived knowledge (6.03 vs 6.63, p=0.04), awareness of weaning plans (6.09 vs 7.06, p=0.01) and satisfaction with communication (5.28 vs 6.19, p=0.01) were higher in Phase II. The intervention group found protocolised weaning useful in their practice (75%): this was scored significantly higher by junior and senior nurses than middle grade nurses (p=0.02). CONCLUSION: We conclude that nurse-directed protocolised-weaning had no effect on nurses' views and perceptions due to the high level of satisfaction which encouraged nurses' participation in weaning throughout. Control group changes are attributed to a 'reactive effect' from being study participants. Weaning protocols provide a uniform method of weaning practice and are particularly beneficial in providing safe guidance for junior staff.
RCT Entities:
BACKGROUND: Internationally, nurse-directed protocolised-weaning has been evaluated by measuring its impact on patient outcomes. The impact on nurses' views and perceptions has been largely ignored. AIM: To determine the change in intensive care nurses' perceptions, satisfaction, knowledge and attitudes following the introduction of nurse-directed weaning. Additionally, views were obtained on how useful protocolised-weaning was to practice. METHODS: The sample comprised nurses working in general intensive care units in three university-affiliated hospitals. Nurse-directed protocolised-weaning was implemented in one unit (intervention group); two ICUs continued with usual doctor-led practice (control group). Nurses' perceptions, satisfaction, knowledge and attitudes were measured by self-completed questionnaires before (Phase I) and after the implementation of nurse-directed weaning (Phase II) in all units. RESULTS: Response rates were 79% (n=140) for Phase 1 and 62% (n=132) for Phase II. Regression-based analyses showed that changes from Phase I to Phase II were not significantly different between the intervention and control groups. Sixty-nine nurses responded to both Phase I and II questionnaires. In the intervention group, these nurses scored their mean perceived level of knowledge higher in Phase II (6.39 vs 7.17, p=0.01). In the control group, role perception (4.41 vs 4.22, p=0.01) was lower and, perceived knowledge (6.03 vs 6.63, p=0.04), awareness of weaning plans (6.09 vs 7.06, p=0.01) and satisfaction with communication (5.28 vs 6.19, p=0.01) were higher in Phase II. The intervention group found protocolised weaning useful in their practice (75%): this was scored significantly higher by junior and senior nurses than middle grade nurses (p=0.02). CONCLUSION: We conclude that nurse-directed protocolised-weaning had no effect on nurses' views and perceptions due to the high level of satisfaction which encouraged nurses' participation in weaning throughout. Control group changes are attributed to a 'reactive effect' from being study participants. Weaning protocols provide a uniform method of weaning practice and are particularly beneficial in providing safe guidance for junior staff.
Authors: Joke M Wielenga; Agnes van den Hoogen; Henriette A van Zanten; Onno Helder; Bas Bol; Bronagh Blackwood Journal: Cochrane Database Syst Rev Date: 2016-03-21
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Authors: P Montravers; C Ichai; H Dupont; J F Payen; G Orliaguet; P Blanchet; Y Malledant; J Albanèse; K Asehnoune; O Bastien; O Collange; J Duranteau; B Garrigues; A Lepape; C Paugam-Burtz Journal: Ann Fr Anesth Reanim Date: 2013-10-16