Anaesthetists' perceptions of facilitative weaning strategies from mechanical ventilator in the intensive care unit (ICU): a qualitative interview study.
OBJECTIVE
This study aimed to examine anaesthetists' perceptions of facilitative weaning from the mechanical ventilator in the intensive care unit (ICU).


METHODS
Explorative qualitative interviews in a phenomenographic reference frame with a purposive sample of 14 eligible anaesthetists from four different ICUs with at least one year of clinical experience of ICU and of ventilator weaning.


RESULTS
Four categories of anaesthetists' perceptions of facilitative decision-making strategies for ventilator weaning were identified. These were the instrumental, the interacting, the process-oriented and the structural strategies" for ventilator weaning. The findings refer to a supportive multidisciplinary holistic ICU quality of care. Choice of strategy for ventilator weaning was flexible and individually tailored to the patients'.


CONCLUSIONS
Choice of strategy was flexible and individually adjustable. Introduction of evidence-based guidelines from ventilator weaning is necessary in the ICU. The guidelines should also cover the responsibilities of various professional groups. Regular evaluations of methods and strategies used in practice need to be implemented. This may facilitate decision-making strategies for ventilator weaning in practice at the ICU. Greater attention needs to focus on family members' experiences. The strategies should be an integral part of continuous staff training.
Department of Medicine and Health, Division of Nursing Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Sara
S
Pettersson
Mariola
M
Melaniuk-Bose
U
U
Edell-Gustafsson
D000776:Anesthesiology / Q000379:methods; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data; D003422:Critical Care / Q000523:psychology; D003657:Decision Making; D019033:Delivery of Health Care, Integrated / Q000379:methods; D055317:Evidence-Based Practice; D005260:Female; D006302:Health Services Research; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D007858:Learning; D008297:Male; D009732:Nursing Care / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic / Q000592:standards; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods; D012938:Social Perception; D012944:Social Support; D013548:Sweden; D015300:Ventilator Weaning / Q000295:instrumentation / Q000451:nursing / Q000523:psychology*; D012122:Ventilators, Mechanical / Q000592:standards*; D000078329:Workforce