Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients.
Juliane Rangel Dantas, Anna Thays Dias Almeida, Karolayne Cabral Matias and 4 others
PMID 36722646WHAT IT FOUND
In adult ICU patients, altered respiratory rate and altered respiratory pattern were the best bedside clues to ineffective airway clearance.
Nurses can use them to identify patients who need airway assessment.
Key findings
01Altered respiratory rate and altered respiratory pattern were the most accurate clinical indicators of ineffective airway clearance.
02Ineffective airway clearance was present in 36.54% of the adult ICU patients.
03The most frequent indicators were dyspnea (43.3%), ineffective cough (42.3%), altered respiratory rate (36.5%), altered respiratory pattern (36.5%), and orthopnea (33.7%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were collected cross-sectionally from one general ICU in northeastern Brazil, so the results may not apply to other ICUs or patient groups. The study excluded unconscious patients without a guardian present and patients readmitted to the ICU during the study, so it may not represent all ICU patients. There were few comparable studies on ineffective airway clearance in adult ICU patients, so it is hard to judge how unusual these accuracy results are. The diagnosis was inferred from a statistical model of indicator combinations rather than from one clear external reference standard.
The easy way to misread this
Do not read altered respiratory rate and altered respiratory pattern as proof that they cause ineffective airway clearance or that acting on them improves outcomes. The study only measured diagnostic accuracy in one ICU and did not test any intervention.