Riglyne vir die respiratoriese verpleging van die kardio-torakale pasient in die post-ekstubasie fase: research

Abstract

Die kritieke sorgverpleegkundige is verantwoordelik en aanspreeklik vir hoë gehalteverpleging van die pasiënt wat koronêre vatchirurgie ondergaan net. Die gespesialiseerde respiratoriese verpleging van hierdie pasiënt in die onmiddellike post-ekstubasie fase is nog nooit nagevors nie. Die vraag ontstaan dus wat is die beste-praktykriglyne vir die respiratoriese verpleging, van 'n kardio-torakale pasiënt wat koronêre vatchirurgie ontvang het, in die onmiddellike post-ekstubasie fase. 'n Kwalitatiewe verkennende en beskrywende navorsingsontwerp is uitgevoer om die menings van kritieke sorgverpleegkundiges werksaam in kritieke sorgeenhede in privaathospitale in Pretoria, oor hierdie respiratoriese verpleging in te samel. Fokusgroeponderhoudvoering is gevoer en die data is aan geselekteerde kardio-torakale chirurge en 'n pulmonoloog vir validering voorgelê. Vervolgens is 'n literatuurkontrole onderneem en riglyne vir die respiratoriese verpleging van die kardio-torakale pasiënt, tydens die post-ekstubasie fase, is geformuleer. Vier hoofdimensies is geïdentifiseer, naamlik kliniese fisiologiese data, kommunikasie, vroeë liggaamlike aktiwiteit en beskikbare hulpbronne. Daar word aanbeveel dat hierdie riglyne nasionaal gevalideer word en dat die gehalte van respiratoriese verpleging van kardio-torakale pasiënte in die post-ekstubasie fase bepaal word.



The critical care nurse is responsible and accountable for quality nursing care of the patient that has undergone cardio-thoracic surgery. The specialised respiratory nursing care of these patients in the immediate post extubation phase, has never been researched. The question arises what are the best practice guidelines for the respiratory nursing care of the cardio-thoracic patient that has undergone coronary artery bypass, with specific reference to the immediate post extubation phase? A qualitative exploratory and descriptive research design was utilised. The views of critical care nurses working in private hospitals in Pretoria, on this specialised respiratory care of patients, were collected by means of a focus group interview. The data was exposed to two selected cardio-thoracic surgeons and one pulmonologist for validation purposes. A literature control was carried out and guidelines for the respiratory nursing care of the cardio-thoracic patient within the post extubation phase, were formulated. Four main dimensions were identifified, viz clinical physiological data, communication, early physical activities and available resources. It is recommended that these guidelines be exposed to national validation and that the quality of respiratory nursing care of the cardio-thoracic patient in the post extubation phase, be determined.


(Health SA Gesondheid: interdisciplinary research journal: 2002 7(1): 56-67)