title: Critical care nurses management of prolonged weaning: an interview study.
abstract: BACKGROUND
  For most critically ill patients requiring mechanical ventilation in the intensive care unit (ICU) weaning is uncomplicated. For the remainder, weaning is a challenge and may result in further complications and increased risk of mortality. Critical care nurses (CCNs) require substantial knowledge and experience to manage patients experiencing prolonged weaning.
  
  
  OBJECTIVE
  The aim of this study was to explore CCNs approach for management of patients experiencing prolonged weaning in the ICU.
  
  
  METHODS
  A descriptive qualitative design.
  
  
  METHODS
  Semi-structured interviews with 19 experienced CCNs were conducted. Data were analysed using content analysis.
  
  
  RESULTS
  Participants used various strategies for weaning that were grouped into four categories: individualized planning for the weaning process, assessing patient's capacity, managing the process and team interaction. The overall theme that emerged was: CCNs drive the weaning process using both a patient centred and targeted approach.
  
  
  CONCLUSIONS
  CCNs in these ICUs performed weaning using a patient centred approach to plan, initiate, assess and establish a holistic weaning process. Team collaboration among all health care practitioners was important. CCNs have a key role in prioritizing weaning and driving the process forward.
  
  
  CONCLUSIONS
  Closeness to the patient and a key role in management of the mechanical ventilated patient in ICU gives the CCN unique potential to develop and create models and tools for prolonged weaning. These tools, specially designed for patients undergoing prolonged weaning, would give focus on continuous planning, collaborating, managing and evaluation in the process of liberating patients from mechanical ventilation.
authors.affiliation: C.-J. Cederwall, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Intensive care unit, Sahlgrenska University Hospital, CIVA, Gröna stråket 2, 413 45 Gothenburg, Sweden.
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Cederwall
authors.forename: Kaety
authors.initials: K
authors.lastname: Plos
authors.forename: Louise
authors.initials: L
authors.lastname: Rose
authors.forename: Amanda
authors.initials: A
authors.lastname: Dübeck
authors.forename: Mona
authors.initials: M
authors.lastname: Ringdal
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D064648:Critical Care Nursing / Q000379:methods*; D003657:Decision Making; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009746:Nursing, Team / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods*; D012121:Respiration, Artificial / Q000451:nursing*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors; D015300:Ventilator Weaning / Q000451:nursing*
keywords: Intensive care unit; Mechanical ventilation; Nursing; Prolonged weaning; Weaning