The role of nurses in preventing adverse events related to respiratory dysfunction: literature review

Considine, Julie 2005, The role of nurses in preventing adverse events related to respiratory dysfunction: literature review, Journal of advanced nursing, vol. 49, no. 6, pp. 624-633, doi: 10.1111/j.1365-2648.2004.03337.x.

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Title The role of nurses in preventing adverse events related to respiratory dysfunction: literature review
Author(s) Considine, JulieORCID iD for Considine, Julie
Journal name Journal of advanced nursing
Volume number 49
Issue number 6
Start page 624
End page 633
Publisher Blackwell Publishing Ltd
Place of publication Oxford, England
Publication date 2005
ISSN 0309-2402
Keyword(s) adverse events
risk management
acute nursing
respiratory dysfunction
literature review
Summary Aims. This paper reports a literature review examining the relationship between specific clinical indicators of respiratory dysfunction and adverse events, and exploring the role of nurses in preventing adverse events related to respiratory dysfunction.

Background. Adverse events in hospital are associated with poor patient outcomes such as increased mortality and permanent disability. Many of these adverse events are preventable and are preceded by a period during which the patient exhibits clearly abnormal physiological signs. The role of nurses in preserving physiological safety by early recognition and correction of physiological abnormality is a key factor in preventing adverse events.

Methods. A search of the Medline and CINAHL databases was conducted using the following terms: predictors of poor outcome, adverse events, mortality, cardiac arrest, emergency, oxygen, supplemental oxygen, oxygen therapy, oxygen saturation, oxygen delivery, assessment, patient assessment, physical assessment, dyspnoea, hypoxia, hypoxaemia, respiratory assessment, respiratory dysfunction, shortness of breath and pulse oximetry. The papers reviewed were research papers that demonstrated a relationship between adverse events and various clinical indicators of respiratory dysfunction.

Results. Respiratory dysfunction is a known clinical antecedent of adverse events such as cardiac arrest, need for medical emergency team activation and unplanned intensive care unit admission. The presence of respiratory dysfunction prior to an adverse event is associated with increased mortality. The specific clinical indicators involved are alterations in respiratory rate, and the presence of dyspnoea, hypoxaemia and acidosis.

Conclusions. The way in which nurses assess, document and use clinical indicators of respiratory dysfunction is influential in identifying patients at risk of an adverse event and preventing adverse events related to respiratory dysfunction. If such adverse events are to be prevented, nurses must not only be able to recognise and interpret signs of respiratory dysfunction, but must also take responsibility for initiating and evaluating interventions aimed at correcting respiratory dysfunction.
Language eng
DOI 10.1111/j.1365-2648.2004.03337.x
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2005, Blackwell Publishing Ltd
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