| Summary: | A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree
of
Master of Science in Nursing
Johannesburg, 2015. === Mechanical ventilation is one of the major interventions in neonatology which provides lifesaving support for infants with respiratory failure. It is indicated in approximately two thirds of all infants admitted to neonatal intensive care units with respiratory acidosis, hypoxia and severe apnoea to improve gaseous exchange and to reduce work of breathing. Although mechanical ventilation is lifesaving, it may cause chronic lung injury resulting in broncho-pulmonary dysplasia. In the South African setting, only 25% of nurses practicing in intensive care units are formally qualified as intensive care nurses and 3% of these in neonatal and paediatric care. As a result care delivery in this specialist unit relies on registered nurses and newly qualified nurses, who are expected to provide quality, advanced nursing care with good patient outcomes. An increasing practice is the development and utilisation of protocols or clinical guidelines based on best available evidence to reduce variability in mechanical ventilation thus reducing risk of complications in this vulnerable patient population.
This study aimed to explore and describe nurses’ views regarding the current mechanical ventilator management protocol, whether it can be adopted to standardise nursing care in a neonatal intensive care unit at a public tertiary academic hospital in Johannesburg.
A qualitative, descriptive and exploratory approach was used in this study. Focus group interviews were conducted and an interview guide was used to collect data. Data were analysed following the process of thematic content analysis by Braun & Clarke.
Three themes emerged from the study which includes current practice, importance of protocols, and development of protocols is a multidisciplinary task. Under current practice theme, there are three subcategories namely; use of the protocol in the neonatal intensive care unit, management of ventilated patients and importance of knowing arterial blood gas. Findings indicated that the current protocol doesn’t guide nursing care and is meant for doctors’ understanding. Nurses felt that there is need for a nursing protocol to guide nursing care. It is also important to involve multidisciplinary team when developing protocols.
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