Document Type

Article

Publication Date

Winter 12-2024

Abstract

Background: Indication of mechanical ventilation are variable and diverse. It is required whenever the child is unable to maintain adequate alveolar oxygenation or ventilation. Objective: To assess the relationship between provided nursing care for children on mechanical ventilation and their clinical outcomes. Setting: The Pediatric Intensive Care Unit (PICU) of Alexandria University Children’s Hospital (AUCH)at El-Shatby. Subjects: Study subjects were included both nurses and children. The first part of the study are all nurses (30) worked at the previously mentioned setting were included this inclusion was regardless of their level of education and years of experience. The second part is a convenient sample of 50 children were aged from 1 month to 3years, just upon starting mechanical ventilation, without any previous complication including ventilator associated pneumonia, pressure ulcer, eye or oral infection. Tools: Three tools were used; characteristics of nurses and children, nursing care Provided for children on Mechanical Ventilation Observational Checklist and clinical outcomes of mechanically ventilated children. Results: All studied nurses had satisfactory level of performance in assessing critically ill children, suction, positioning, chest physiotherapy, skin care,eye care and oral care procedures. There was no statistical significant relation between clinical outcomes and the total mean score of nurses’ care performance. Conclusion: all studied nurses had satisfactory level of performance regarding care provided for children on mechanical ventilation. All studied children had positive clinical outcomes except less than one third of them of them who had ventilator associated pneumonia (VAP) at the third days from admission and more than one third of them had VAP after the fifth days from admission

Comments

Recommendations: Based on the results of the current study, the following recommendations are suggested:

1- Manual handout should be provided to nurses containing all necessary information about procedures related to postural drainage in chest physiotherapy and oral care to mechanically ventilated children.

2- Graphs show assessment process initial, primary, secondary to the critically ill children.

3- Periodically workshop for nurses to refresh their knowledge and performance to avoid any complication and enhancement their performances.

4- Apply Braden scale for predicting pressure ulcer risk in children in the unit.

5. Written protocol for oral care procedure .

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