Physicians' perceptions of protocol-directed weaning in an intensive care unit in Norway.
The aim of this paper is to identify physicians' perceptions of protocol-directed weaning from mechanical ventilation in an intensive care unit in Norway. Errors occur in the absence of procedures, plans, and a team culture. Standardized weaning protocols, or pathways, offer a systematic approach. The focus group method was used. Four themes emerged: (i) acceptance, where the participants perceived the protocol as having a positive influence on the weaning process, although some barriers were identified, such as its failure to facilitate the "difficult-to-wean" patient; (ii) indignant responses, which gave the impression that the protocol was prescribed for the benefit of the nurses; (iii) ambivalence was evident in the two different approaches to the weaning process when problems occurred, which were "directing" and "collaborating"; and (iv) continuity and professional competence were perceived as important aspects of the weaning process. An unclear pattern of responsibility and poor interprofessional collaboration and communication were reported.
Hansen
Britt Saetre
BS
Department of Anesthesia and Intensive Care, Stavanger Hospital, Stavanger, Norway. habs@sus.no
Severinsson
Elisabeth
E
D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000379:methods / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009664:Norway; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D017009:Professional Autonomy; D011787:Quality of Health Care; D012121:Respiration, Artificial / Q000592:standards; D015300:Ventilator Weaning / Q000451:nursing / Q000592:standards*