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Research Paper
- Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients
- Kim, Soomi , Kim, Chul-Gyu
- J Korean Acad Nurs 2023;53(3):275-294. Published online June 30, 2023
- DOI: https://doi.org/10.4040/jkan.22109
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Abstract
PDF - Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.
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Original Articles
- The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygenation and the Amount of Lung Secretions in Premature Infants with Respiratory Distress Syndrome
- Ahn Young Mee
- Journal of Korean Academy of Nursing 1998;28(3):591-601. Published online March 29, 2017
- DOI: https://doi.org/10.4040/jkan.1998.28.3.591
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- Meta-Analysis on the Effectiveness of Interventions Applied to Preventing Endotracheal Suction-Induced Hypoxemia
- Hyun Soo Oh
- Journal of Korean Academy of Nursing 2003;33(1):42-50. Published online March 28, 2017
- DOI: https://doi.org/10.4040/jkan.2003.33.1.42
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Abstract
Purpose This study was conducted to investigate the effects of the suction-induced hypoxemia interventions.
Method 30 suction-induced hypoxemia interventions were reviewed for the purpose of meta-analysis.
Result The study showed that both preoxygenation and insufflation were the most frequently examined oxygenation time periods, and hyperoxygenation combined with hyperinflation was the most commonly applied oxygenation method in order to prevent suction-induced hypoxemia. The greatest effect was obtained by providing oxygenation before and after suctioning, whereas negative effect(the contrary results from the study hypotheses) was frequently obtained by applying insufflation only. Applying hyperoxygenation combined with hyperinflation had the greatest effect over that of applying hyperoxygenation only, even though the difference between effect sizes of both methods were statistically significant.
Conclusion The results of meta-analysis showed that the occurrence rate of hypoxemia after suctioning was significantly reduced with the overall interventions for hypoxemia (decreasing 40% of occurrence rate), independent with time periods or methods for providing oxygenation.
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