Clinical Judgment of Nurses to Continue Noninvasive Positive-Pressure Ventilation(NPPV) in Patients with Acute Respiratory Failure

Abstract

1 2 Hiroaki Murata Tomoko Inoue NPPV 14 NPPV NPPV NPPV NPPV This study aimed to delineate the clinical judgment of nurses to continue noninvasive positivepressure ventilation NPPV in patients with acute respiratory failure, and to obtain suggestions for improving nursing care. Study participants consisted of 14 nurses. Data gathered by participantobservation and semi structured interviews were analyzed using Modified Grounded Theory Approach. The results of the analysis suggested that nurses use past experiences to anticipate difficulty in continuing , assess interfering factors of continuation and then choosing nursing support for continuation . The results intimated a process of clinical judgment in which, through reflection , knowledge was accumulated with past experiences and circled back to anticipating difficulty in continuing. Observational data suggested that nurses with ample experiences with NPPV were better than others at anticipating difficulty in continuing, and that they made clinical judgments with an emphasis on eliciting patient understanding in their own clinical judgment and on the importance of an active livelihood with NPPV. Application of these findings to nursing education can be useful for care in continuing safer and more comfortable NPPV.