title: Lung recruitment--a nurse and/or physician task. A national survey on requirements for education, regulations and guidelines.
abstract: International and national guidelines on requirements for performing lung recruitment manoeuvres are lacking. This paper presents a nationwide descriptive survey of the occurrence of and conditions for lung recruitment in adult patients treated with mechanical ventilation in intensive care units (ICUs) in Sweden. All ICUs except neurological, cardiac, paediatric and neonatal ICUs were invited (N=73); of these, 60 ICUs participated in the study (82%). The main outcome measures were prevalence of lung recruitment, whether ICU nurses and/or physicians carried out lung recruitment, requirements for nurses to perform lung recruitment and the existence of local guidelines. Lung recruitment was performed at 92% of the ICUs. Only physicians performed lung recruitment at 27 ICUs (49%), and in 28 units (51%) both physicians and nurses performed this treatment. Lung recruitment was performed more often in units where both physicians and nurses performed lung recruitment than in units where only physicians performed the manoeuvres (46% vs. 12%, p=0.03). Further, local guidelines on lung recruitment manoeuvres were more common in units where both physicians and nurses performed this treatment (71% vs. 41%, p=0.02). The results suggest that recommendations of repeated and prompt lung recruitment manoeuvres are better met if nurses, along with physicians, perform lung recruitment.
authors.affiliation: Intensive Care Unit, Capio S:t Gorans Hospital, St. Goransplan 1, SE 11281 Stockholm, Sweden. carina.pilten@capio.se
authors.forename: Carina
authors.initials: C
authors.lastname: Piltén
authors.forename: Ann Catrine
authors.initials: AC
authors.lastname: Eldh
mesh_terms: D000328:Adult; D003422:Critical Care / Q000458:organization & administration*; D032022:Delegation, Professional / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007318:Inservice Training; D008505:Medical Staff, Hospital / Q000193:education / Q000458:organization & administration; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D010819:Physician's Role; D011175:Positive-Pressure Respiration / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D017009:Professional Autonomy; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors