End-tidal carbon dioxide as a measure of stress response to clustered nursing interventions in neurologic patients

Laura Genzler, Pamela Jo Johnson, Neha Ghildayal, Sarah Pangarakis, Sue Sendelbach

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Guidelines recommend rest periods between nursing interventions for patients with a neurologic diagnosis but do not specify a safe number of interventions. Objectives: To examine the physiological stress response to clustered nursing interventions in neurologic patients receiving mechanical ventilation. Methods: Prospective, comparative, descriptive design to examine effects of clustered interventions (≥6 interventions in a single nursing interaction) versus nonclustered interventions on patients' stress. Stress response was defined as a 10% change in end-tidal carbon dioxide from before the interaction to (1) 5 and 10 minutes after the start of the interaction, (2) at the end of the interaction, and (3) 15 minutes after the interaction. Results: The mean percent change in end-tidal carbon dioxide at 5 minutes differed significantly between patients with clustered interventions and patients with nonclustered interventions (6.7% vs -0.2%; P = .001). Patients with clustered interventions were significantly more likely than patients with low clustering to exhibit a stress response at 5 minutes (24.3% vs 0%; P = .01). Conclusions: Neurologic patients receiving mechanical ventilation who experienced 6 or more clustered nursing interventions showed a higher mean change in end-tidal carbon dioxide than did patients who received fewer than 6 clustered interventions. These findings suggest that providing fewer interventions during 1 nursing interaction may minimize induced stress in neurologic patients receiving mechanical ventilation. (American Journal of Critical Care. 2013;22:239-245).

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalAmerican Journal of Critical Care
Volume22
Issue number3
DOIs
StatePublished - May 1 2013

Fingerprint

Carbon Dioxide
Nervous System
Nursing
Artificial Respiration
Physiological Stress
Critical Care
Cluster Analysis
Guidelines

Cite this

End-tidal carbon dioxide as a measure of stress response to clustered nursing interventions in neurologic patients. / Genzler, Laura; Johnson, Pamela Jo; Ghildayal, Neha; Pangarakis, Sarah; Sendelbach, Sue.

In: American Journal of Critical Care, Vol. 22, No. 3, 01.05.2013, p. 239-245.

Research output: Contribution to journalArticle

Genzler, Laura ; Johnson, Pamela Jo ; Ghildayal, Neha ; Pangarakis, Sarah ; Sendelbach, Sue. / End-tidal carbon dioxide as a measure of stress response to clustered nursing interventions in neurologic patients. In: American Journal of Critical Care. 2013 ; Vol. 22, No. 3. pp. 239-245.
@article{35610af24a194617b756177e0649a1f7,
title = "End-tidal carbon dioxide as a measure of stress response to clustered nursing interventions in neurologic patients",
abstract = "Background: Guidelines recommend rest periods between nursing interventions for patients with a neurologic diagnosis but do not specify a safe number of interventions. Objectives: To examine the physiological stress response to clustered nursing interventions in neurologic patients receiving mechanical ventilation. Methods: Prospective, comparative, descriptive design to examine effects of clustered interventions (≥6 interventions in a single nursing interaction) versus nonclustered interventions on patients' stress. Stress response was defined as a 10{\%} change in end-tidal carbon dioxide from before the interaction to (1) 5 and 10 minutes after the start of the interaction, (2) at the end of the interaction, and (3) 15 minutes after the interaction. Results: The mean percent change in end-tidal carbon dioxide at 5 minutes differed significantly between patients with clustered interventions and patients with nonclustered interventions (6.7{\%} vs -0.2{\%}; P = .001). Patients with clustered interventions were significantly more likely than patients with low clustering to exhibit a stress response at 5 minutes (24.3{\%} vs 0{\%}; P = .01). Conclusions: Neurologic patients receiving mechanical ventilation who experienced 6 or more clustered nursing interventions showed a higher mean change in end-tidal carbon dioxide than did patients who received fewer than 6 clustered interventions. These findings suggest that providing fewer interventions during 1 nursing interaction may minimize induced stress in neurologic patients receiving mechanical ventilation. (American Journal of Critical Care. 2013;22:239-245).",
author = "Laura Genzler and Johnson, {Pamela Jo} and Neha Ghildayal and Sarah Pangarakis and Sue Sendelbach",
year = "2013",
month = "5",
day = "1",
doi = "10.4037/ajcc2013109",
language = "English (US)",
volume = "22",
pages = "239--245",
journal = "American Journal of Critical Care",
issn = "1062-3264",
publisher = "American Association of Critical Care Nurses",
number = "3",

}

TY - JOUR

T1 - End-tidal carbon dioxide as a measure of stress response to clustered nursing interventions in neurologic patients

AU - Genzler, Laura

AU - Johnson, Pamela Jo

AU - Ghildayal, Neha

AU - Pangarakis, Sarah

AU - Sendelbach, Sue

PY - 2013/5/1

Y1 - 2013/5/1

N2 - Background: Guidelines recommend rest periods between nursing interventions for patients with a neurologic diagnosis but do not specify a safe number of interventions. Objectives: To examine the physiological stress response to clustered nursing interventions in neurologic patients receiving mechanical ventilation. Methods: Prospective, comparative, descriptive design to examine effects of clustered interventions (≥6 interventions in a single nursing interaction) versus nonclustered interventions on patients' stress. Stress response was defined as a 10% change in end-tidal carbon dioxide from before the interaction to (1) 5 and 10 minutes after the start of the interaction, (2) at the end of the interaction, and (3) 15 minutes after the interaction. Results: The mean percent change in end-tidal carbon dioxide at 5 minutes differed significantly between patients with clustered interventions and patients with nonclustered interventions (6.7% vs -0.2%; P = .001). Patients with clustered interventions were significantly more likely than patients with low clustering to exhibit a stress response at 5 minutes (24.3% vs 0%; P = .01). Conclusions: Neurologic patients receiving mechanical ventilation who experienced 6 or more clustered nursing interventions showed a higher mean change in end-tidal carbon dioxide than did patients who received fewer than 6 clustered interventions. These findings suggest that providing fewer interventions during 1 nursing interaction may minimize induced stress in neurologic patients receiving mechanical ventilation. (American Journal of Critical Care. 2013;22:239-245).

AB - Background: Guidelines recommend rest periods between nursing interventions for patients with a neurologic diagnosis but do not specify a safe number of interventions. Objectives: To examine the physiological stress response to clustered nursing interventions in neurologic patients receiving mechanical ventilation. Methods: Prospective, comparative, descriptive design to examine effects of clustered interventions (≥6 interventions in a single nursing interaction) versus nonclustered interventions on patients' stress. Stress response was defined as a 10% change in end-tidal carbon dioxide from before the interaction to (1) 5 and 10 minutes after the start of the interaction, (2) at the end of the interaction, and (3) 15 minutes after the interaction. Results: The mean percent change in end-tidal carbon dioxide at 5 minutes differed significantly between patients with clustered interventions and patients with nonclustered interventions (6.7% vs -0.2%; P = .001). Patients with clustered interventions were significantly more likely than patients with low clustering to exhibit a stress response at 5 minutes (24.3% vs 0%; P = .01). Conclusions: Neurologic patients receiving mechanical ventilation who experienced 6 or more clustered nursing interventions showed a higher mean change in end-tidal carbon dioxide than did patients who received fewer than 6 clustered interventions. These findings suggest that providing fewer interventions during 1 nursing interaction may minimize induced stress in neurologic patients receiving mechanical ventilation. (American Journal of Critical Care. 2013;22:239-245).

UR - http://www.scopus.com/inward/record.url?scp=84877349658&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877349658&partnerID=8YFLogxK

U2 - 10.4037/ajcc2013109

DO - 10.4037/ajcc2013109

M3 - Article

C2 - 23635933

AN - SCOPUS:84877349658

VL - 22

SP - 239

EP - 245

JO - American Journal of Critical Care

JF - American Journal of Critical Care

SN - 1062-3264

IS - 3

ER -