Abstract

ObjectiveThis study aimed to describe registered nurses’ (RNs) experiences of providing respiratory care in relation to hospital acquired pneumonia (HAP), specifically among patients with acute stroke being cared for at in-patient stroke units.BackgroundOne of the most common and serious respiratory complications associated with acute stroke is HAP. Respiratory care is among the fundamentals of patient care, and thus competency in this field is expected as part of nursing training. However, there is a paucity of literature detailing RNs’ experiences with respiratory care in relation to HAP, specifically among patients with acute stroke, in the context of stroke units. As such, there is a need to expand the knowledge base relating to respiratory care focusing on HAP, to assist with evidence-based nursing.DesignA qualitative descriptive study.MethodEleven RNs working in four different acute stroke units in Southern Sweden participated in the current study. The data were collected through semi-structured interviews, and the transcribed interviews were analysed using inductive content analysis.ResultsThree overarching categories were identified: (1), awareness of risk assessments and risk factors for HAP (2) targeting HAP through multiple nursing care actions, and (3) challenges in providing respiratory care to patients in risk of HAP. These reflected the similarities and differences in the experiences that RNs had with providing respiratory care in relation to HAP among in-patients with acute stroke.ConclusionsThe findings from this study suggest that the RNs experience organisational challenges in providing respiratory care for HAP among patients with acute stroke. Respiratory care plays a vital role in the identification and prevention of HAP, but our findings imply that RNs’ knowledge needs to be improved, the fundamentals of nursing care need to be prioritised, and evidence-based guidelines must be implemented. RNs would also benefit from further education and support, in order to lead point-of-care nursing in multidisciplinary stroke teams.

Highlights

  • One of the most common and serious respiratory complications associated with acute stroke is hospital acquired pneumonia (HAP)

  • The findings from this study suggest that the Registered nurses (RN) experience organisational challenges in providing respiratory care for HAP among patients with acute stroke

  • Respiratory care plays a vital role in the identification and prevention of HAP, but our findings imply that RNs’ knowledge needs to be improved, the fundamentals of nursing care need to be prioritised, and evidence-based guidelines must be implemented

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Summary

Introduction

One of the most common and serious respiratory complications associated with acute stroke is HAP. Recovery from an acute stroke has been found to be negatively impacted if, post stroke, the patient acquires HAP as it increases the likelihood of dependency [3] and the time in care by up to 7.5 days [4]. This is significant, as around 15 million people worldwide suffer from stroke annually [5], underscoring the importance of improving knowledge relating to respiratory nursing care, especially to prevent and target complications such as pneumonia among this substantial group of patients

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