Best Practices for Patients Receiving Mechanical Ventilation: A Scoping Review

ICU’s in the US care for 5 million patients annually with 1-2 million requiring mechanical ventilation (MV) (SCCM | Critical Care Statistics, n.d.). ICU care is highly specialized and designated for critically ill patients who require intensive monitoring, life support, stabilization of acute or life-threatening illness, comprehensive management of injury and illness, and maximization of comfort for dying patients (SCCM | Critical Care Statistics, n.d.). MV is the most used short-term life support technique in ICUs (Pham et al., 2017). It is required for various indications, from acute life-threatening conditions to scheduled surgical procedures (Pham et al., 2017). Patients requiring MV have an increased risk of developing life-threatening complications and are more likely to experience poor outcomes (AHRQ Safety Program for Mechanically Ventilated Patients, 2017). These complications can be associated with negative outcomes such as longer stays in intensive care settings and the hospital, increased healthcare costs, increased disability and mortality, and decreased quality of life. In order to improve delivery of care, patient outcomes and lower healthcare cost the author of this capstone conducted a scoping review of literature from 2013 to 2023. 539 articles from PubMed and Science Direct were screened by title and abstracted. Twenty-five articles were accepted to read the full text with nine meeting the inclusion criteria and included the final analysis. The results showed that interventions to improve patient outcomes and reduce complications should focus on the importance of getting patients off the ventilator and transferred out of critical care faster. Strategies that will decrease complications of mechanical ventilation are: avoiding intubation, minimizing sedation, performing daily Coordinated SATs and SBTs, implementing protocols for early mobility, and practicing low tidal volume ventilation