Nurses' knowledge, attitude, and perceived barriers toward protective lung strategies of pediatrics mechanically ventilated patients in a tertiary care hospital in Pakistan.

IF 1.7 Q3 CRITICAL CARE MEDICINE
Acute and Critical Care Pub Date : 2025-02-01 Epub Date: 2025-02-19 DOI:10.4266/acc.004761
Tasnim Zainib, Salma Rattani, Nimira Asif, Hussain Maqbool Ahmed Maqbool
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Abstract

Background: Protective lung strategies (PLS) are guidelines about recent clinical advances that deliver an air volume compatible with the patient's lung capacity and are used to treat acute respiratory distress syndrome. These mechanical ventilation guidelines are not implemented within intensive care units (ICUs) despite strong evidence-based recommendations and a dedicated professional staff. Nurses' familiarity with clinical guidelines can bridge the gap between actual and recommended practice. However, several barriers undermine this process. The objectives of this study were to identify those barriers and explore the knowledge, attitudes, and behavior of ICU nurses regarding the implementation of PLS.

Methods: This was a descriptive, cross-sectional study. The participants were nurses working in the six ICUs of a pediatric tertiary care hospital in Lahore, Pakistan. Using purposive sampling with random selection, the total sample size was 137 nurses. A summative rating scale was used to identify barriers to the implementation of PLS.

Results: Overall, the nurses' barrier score was high, with a mean of 66.77±5.36. Across all the barriers subscales, attitude was a much more significant barrier (35.74±3.57) to PLS than behavior (6.53±1.96), perceived knowledge (17.42±2.54), and organizational barriers (7.08±1.39). Knowledge-related barriers were also significantly high. Conclusion: This study identified important barriers to PLS implementation by nurses, including attitudes and knowledge deficits. Understanding those barriers and planning interventions to address them could help to increase adherence to low tidal volume ventilation and improve patient outcomes. Nurses' involvement in mechanical ventilation management could help to safely deliver air volumes compatible with recommendations.

巴基斯坦某三级医院儿科机械通气患者肺保护策略的护士知识、态度和感知障碍
背景:肺保护策略(PLS)是最近临床进展的指导方针,提供与患者肺活量相容的空气量,用于治疗急性呼吸窘迫综合征。尽管有强有力的循证建议和专门的专业人员,但这些机械通气指南并未在重症监护病房(icu)实施。护士对临床指南的熟悉程度可以弥合实际操作与推荐操作之间的差距。然而,一些障碍阻碍了这一进程。本研究的目的是确定这些障碍,并探讨ICU护士在实施pls方面的知识、态度和行为。方法:这是一项描述性、横断面研究。参与者是在巴基斯坦拉合尔一家儿科三级护理医院的六个icu工作的护士。采用随机抽样的有目的抽样方法,总样本量为137名护士。结果:总体而言,护士的障碍得分较高,平均为66.77±5.36分。在所有障碍子量表中,态度(35.74±3.57)比行为(6.53±1.96)、感知知识(17.42±2.54)和组织障碍(7.08±1.39)更显著。与知识相关的障碍也非常高。结论:本研究确定了护士实施PLS的重要障碍,包括态度和知识缺陷。了解这些障碍并计划干预措施来解决这些障碍有助于增加对低潮气量通气的依从性并改善患者的预后。护士参与机械通气管理有助于安全输送符合建议的风量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acute and Critical Care
Acute and Critical Care CRITICAL CARE MEDICINE-
CiteScore
2.80
自引率
11.10%
发文量
87
审稿时长
12 weeks
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