Impaired Adult Ventilatory Weaning Response (00430) Undergoing Cardiac Surgery: A Cross-Sectional Study.

Abstract

ObjectiveTo analyze the clinical validity evidence of the nursing diagnosis Impaired Adult Ventilatory Weaning Response (00430) in adults hospitalized in a cardiothoracic recovery unit following cardiac surgery.MethodA cross-sectional, diagnostic accuracy study was conducted with 115 patients. The prevalence of the nursing diagnosis was estimated, and measures of effect size for its etiological factors and accuracy measures for its clinical indicators were evaluated.ResultsThe estimated prevalence of the nursing diagnosis was 31.53%. Seven clinical indicators demonstrated high specificity: respiratory discomfort (Sp = 0,97), hypercapnia (Sp = 0,96), decreased level of consciousness (Sp = 93), elevated central venous pressure (Sp = 92), alteration of blood pressure relative to baseline parameters (Sp = 0,91), restlessness (Sp = 0,86), and hemodynamic instability (Sp = 0,81). Hemodynamic instability also proved to be a sensitive indicator (Se = 0,72) for determining the presence of the diagnosis. The etiological factors of ineffective airway clearance and metabolic disturbances were associated with odds ratios of 3.53 (95% CI: 1.44-8.63) and 2.53 (95% CI: 1.02-6.29) for developing the outcome, respectively.ConclusionThe evidence gathered can substantiate nursing interventions for Impaired Adult Ventilatory Weaning Response (00430) in this patient population.Implications for nursing practiceThis study has potential to contribute to better encompass the specific characteristics of surgical patients.