Nurses' strategies to enable continuous positive airway pressure therapy in a general medical ward context: A qualitative study.

Abstract

Continuous positive airway pressure is a non-invasive therapy beneficial for patients with acute respiratory failure. The need for this therapy outside intensive care units is growing, but nurses face many challenges to enable this therapy in general medical wards. The aim of the study was to explore nurses' strategies for enabling continuous positive airway pressure therapy in a general medical ward context. An explorative qualitative design was used including semi-structured interviews with 15 Swedish nurses. Data were analysed using a conventional content analysis. The nurses' strategies included a non-hierarchical approach when utilising an intra- and interprofessional collaboration. Inexperience was compensated for by collaboration. Nurses' strategies involved advanced patient-centred care using interventions to manage and ease the patient's treatment and discomfort. The creation of an alliance with the patient was crucial to prevent treatment failure. The strategies were interrelated and considered as parts of a whole. Nurses described the strategy of a dynamic team that could be enlarged or decreased in tandem with other professionals, depending on the situation and the nurses' needs. Nurses need to have an attentive response to the patients' physical, psychosocial and relational needs and to maintain trust for a positive therapy outcome.