Efficacy of a Nursing Checklist During Mechanical Ventilation in Patients With Severe Pneumonia.

Abstract

Background: Severe pneumonia is a respiratory disease associated with high morbidity and mortality, often necessitating mechanical ventilation. However, prolonged mechanical ventilation is associated with an increased risk of complications and higher use of healthcare resources. The efficacy of a nursing checklist on airway management during mechanical ventilation in patients with severe pneumonia has not been extensively investigated.

Aim: This study aimed to evaluate the effectiveness of a nursing checklist in improving airway management during mechanical ventilation for patients with severe pneumonia.

Study design: A prospective, assessor-blind, single-centre, randomized controlled trial was conducted, and 100 patients diagnosed with severe pneumonia who required mechanical ventilation were enrolled in the study. Participants were randomly assigned to either the Nursing Checklist group (NC group) or the Routine Management group (RM group). The primary outcome measures included the duration of mechanical ventilation, length of stay in the intensive care unit, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, tidal volume (TV), respiratory rate (f) and the oxygenation index (the ratio of arterial oxygen partial pressure [PaO₂] to fractional inspired oxygen [FiO₂] or PaO₂/FiO₂).

Results: The duration of mechanical ventilation was significantly shorter among patients in the NC group compared to those in the RM group (p < 0.001), but the difference in length of stay in the intensive care unit (ICU) between the two groups was not statistically significant (p > 0.05). By Day 14, the APACHE II score in the NC group was significantly lower than that in the RM group (p < 0.001), and improvements in TV, f and PaO₂/FiO₂ in the NC group were also statistically significant compared to the RM group (p < 0.001).

Conclusions: In this study, it was observed that the implementation of a nursing checklist was associated with significant improvements in the quality of airway care and patient outcomes during mechanical ventilation in patients with severe pneumonia, leading to a significant reduction in the duration of mechanical ventilation and improved oxygenation status and prognosis of patients.

Relevance to clinical practice: These findings provide valuable insights for future research and clinical practice, and it is recommended that the use of a nursing checklist be integrated into clinical practice to improve the quality and safety of airway management for patients with severe pneumonia on mechanical ventilation.