Holistic Nursing Care of Patient with Mechanical Ventilation Project

This clinical project proposal focuses on the holistic nursing care of patients undergoing mechanical ventilation, a critical aspect of intensive care. The project aims to explore the nature of holistic care received by these patients from the perspective of critical care nurses, establish methods to promote continuous care, foster human dignity and overall well-being, identify issues facing mechanically ventilated patients, and relate these issues to student practice. The literature review emphasizes the importance of patient-centered approaches, pain management, stressor reduction, and appropriate sedation. It highlights the role of evidence-based nursing care, understanding indicators for mechanical ventilation, and addressing patient comfort needs through pharmacological, nursing care, and complementary interventions. The project also touches upon the complexities of weaning patients from mechanical ventilation and the importance of individualized assessment and care.

Running Head: HOLISTIC NURSING CARE OF PATIENT WITH MECHANICAL VENTILATION 1.
Holistic Nursing Care of the Patient with Mechanical Ventilation
Name
Institution

HOLISTIC NURSING CARE OF PATIENT WITH MECHANICAL VENTILATION 2.
Introduction
One of the most critical and challenging aspects of care for many nurses in essential
environments of care is administering effective patient care towards improving healthcare
outcomes for mechanically ventilated patients. Baid, (2016) provides that the process of
mechanical ventilation is a necessary therapeutic intervention in nursing for many patients, it is
associated with potential or actual complications which present further challenges for critically
ill patients. As a result, many of the patients admitted into the various healthcare facility
intensive care unit require airway maintenance and as well as mechanical ventilation support.
This is because nursing management of the mechanically ventilated patients is very challenging
on many levels and these patients, therefore, nursing care and control of the critically ill
mechanically ventilated patients has increasingly become so demanding and necessitates the
development of a patient-focused approach towards achieving improved health care outcomes. It
is therefore paramount that all qualified nurses working in any critical care environment to
understand the indication for the use of mechanical ventilation, the most common associated
complications with patients as well as the modes of ventilation delivery (Barton, Vanderspank-
Wright & Shea, 2016). Although the mechanically ventilated patient is a lifesaving process, it is
also important to note that it can cause both physiological and psychological complications for
the patient and hence the need for the development of a patient-centered care approaches.
The purpose of this research paper is, therefore, to develop a project proposal on the topic
addressing the holistic nursing care of patients with mechanical ventilation. This will be achieved
through the analysis and evaluation of various literature materials to provide more understanding
on the topic and why it is critical for any nursing student to be equipped with knowledge and

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skills towards addressing the challenges facing the mechanically ventilated patients to improve
their healthcare outcomes.
Objectives of the clinical project
The clinical project will seek to achieve various goals in line with improving the
healthcare outcomes for the patients who are mechanically ventilated in the different critical care
environments or intensive care units. These include;
Primary Objective
To explore the nature of holistic care received by mechanically ventilated patients from the
perspectives of the critical care nurses.
Secondary objectives
 To establish the various methods and techniques which can be used to promote the
development of continuous care for the patients
 To explore in a holistic view the patient care towards fostering human dignity as well as
the overall development of patients well being
 To identify the various issues facing mechanically ventilated patients in different critical
care environments and their implications to the patients
 To establish the multiple problems facing the mechanically ventilated patients and their
relevance to students practice through a holistic and comprehensive manner.
Literature Review/Content analysis
Given the nature of care for the mechanically ventilated patients and the likely challenges
or complications to the patient’s different scholars have developed various studies which are

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critical in understanding how nurses can develop holistic care for the patients with a mechanical
ventilator. Schmidt (2017) argues that it is essential to realize that as much as technological
advancements have played a critical role towards improving the nature of patient care in critical
care environments, nurses operating in such situations have a responsibility of developing a
patient-focused or centered approach towards enhancing the patients’ healthcare outcomes. This
is because even though mechanical ventilation provides therapeutic intervention to the patients, it
is associated with an increased likelihood of further complications which may later present
severe impact for the critically ill patient. It is, therefore, the role of every nurse to develop
effective strategies for patients care to reduce possibilities of developing these complications and
promote the development of positive health outcomes for the patients (Yoshida, Fujino, Amato
& Kavanagh, 2017). Therefore most of the literature developed by various scholars have focused
on patient health review and the different management strategies for patient indicators such as
pain, stressors and sedation. These management strategies play a critical role in relieving the
patients from pain when weaning them from mechanical ventilation and reduce further
complications associated with the process.
Mechanically ventilated patients are at risk of both physiological and psychological
complications which necessitate the development of a patient-centered approach to care at the
critical care environments (Prime et al., 2016). The effective management of these complications
has become very challenging to the nurses and especially because, weaning patients has become
a complex process of mechanical ventilation and hence it is highly challenging process for nurses
requiring an overall patient assessment, continuity of care and increased patient centered or focus
in all aspects of patients’ needs by the critical care nurses.

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The care of the patients with mechanical ventilation is at the core of a nurse clinical
practice in an ICU or intensive care unit, and therefore it is very critical to the development of
comprehensive care for the patients (Hodgson & Tipping, 2017). To reduce the array of
complication or challenges resulting from mechanical ventilation, most scholars have argued that
evidence based nursing care is pivotal to delivery of quality health outcomes for the
mechanically ventilated patients. To achieve nursing care based on evidence it is critical for the
nurses working in the intensive care unit (ICU) to develop an understanding of the various
indicators which will necessitate the use of mechanical ventilation, the various modes of
ventilation delivery to patients and the most common patient associated complications
(Brochard, Slutsky & Pesenti, 2017). It is the mechanical ventilators which play a critical role in
assisting the movement of gases or air into and out of the patient’s lungs while minimizing the
effect of breathing for the patients. The indicators for the use of mechanical ventilation which
every nurse should take note of include; cardiorespiratory arrest and central nervous system
depression among patients, the management of type 1 and two respiratory failures, the removal
of CO2 and the control of oxygenation. All these indicators play a critical role to the
development of nursing care based on evidence which results to improved patients outcomes as
well as increased healthcare efficiency in the various essential units of care or environments
(Quraishi, McCarthy, Blum, Cobb & Camargo, 2016). This is therefore relevant for any nursing
student as it prepares them to understand the various issues which may result from mechanical
ventilation and thus help in developing the necessary actions or steps towards planning for
effective care.
The comfort needs for the patients receiving mechanical ventilation is very critical to
their recovery or healing process (Rustam, Kongsuwan & Kitrungrote, 2017). In most case the

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patients can be disturbed for many reasons and hence contributing to negative impacts because of
the unmet comfort needs. According to the theory of comfort by Kolcabas, patients comfort may
be enhanced if their comfort needs of support can be met in the four centers of support
including; the physical comfort center, environmental, psychospiritual and sociocultural comfort
centers. There is, therefore, an increased need for the nurse to develop a quality comfort care for
the patients dependent on mechanical ventilation by identifying the causative factors that may
disturb their comfort during mechanical ventilation process and develop appropriate the
interventions to promote comfort for the patients. Based on the theory of comfort by Kolcabas,
physical comfort are the outcomes of patient reaction to an illness which could be through a
stimulus or not (Minton & Batten, 2016).
The psychospiritual comfort, on the other hand, relates to the internal patient awareness
such as self-esteem, sexuality, life meaning, identity as well as an individual relationship to a
higher being or order. This are essential comfort needs which may not be easy for the nurses to
identity in a patient and hence possible to subject them to harm without their knowledge and
hence the reason why nurses are required to have knowledge on these psychospiritual patient’s
needs. Environmental comfort is associated with the various external surrounding and conditions
of the patients who are likely to affect their wellbeing and include things like light, heat, noise as
well as their safety. Lastly, sociocultural comfort refers to things like interpersonal, family and
societal relationships (Faria, Pontífice-Sousa & Gomes, 2018). These patients are critical to the
patients and comfort is an inherent component of basic human needs and an outcome in nursing
care.
Developing quality comfort care in nursing care is a critical part of the healing process
and an essential element of holistic care and culture care. Like any other person patients require a

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special type of comfort that is critical for their healing process more so because of the critical
nature of their critical health conditions. Therefore it is necessary for nurses to review and
synthesize the knowledge of their care from existing evidence regarding comfort needs and
interventions to promote comfort in patients with mechanical ventilation (Jakimowicz & Perry,
2015). Most important it is critical to note that patients comfort may increase if their comfort
needs are met by appropriate interventions. These intervention strategies can be divided into;
pharmacological interventions, nursing care interventions as well as complementary and
alternative interventions. The most likely pharmacological interventions include methods such as
the use of analgesics and sedative therapy to relieve patients of discomfort as well as improve
their ability to endure the challenges and effects of mechanical ventilation in a humane manner.
Nursing care interventions which can be implemented by nurse include patients’ proposer
positioning, mouth case as well as the management of various stress factors such as sleep
disturbance, isolation and ineffective communication (Delgado, 2017). Nurses can achieve this
by using relevant nursing and medical technologies as well as psychosocial care measures. There
are various technologies which have been developed to help the nurses offer exceptional services
to patients with mechanical ventilation. The technologies are used to detect any changes and
record the various response behavior to treatment and therefore is it necessary for nurses to have
or equip themselves with the necessary technological skills and knowledge. Lastly, the
complementary and alternative measures include patient’s relaxation massage, music therapy,
therapeutic touch and emphatic physical patient contacts. Adherence or developing strategies to
understand patient comfort needs and develop appropriate intervention strategies is an essential
element of holistic nursing care towards patients with mechanical ventilation.

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Another critical issue of nursing care is weaning patients from mechanical ventilation.
Some of the complications occur to patients after they are taken out of the mechanical ventilator.
In most case, the length at which the patients spent on the mechanical ventilator varies from
other patients (Laerkner, Egerod & Hansen, 2015). Therefore nurse in critical care units should
take note of this differences and ensure that weaning should occur without delay to improve
patient’s response to healing and recovery and reduce the risk of complications such as increased
risk of pneumonia and airway trauma and their associated costs. For instance, the health status of
racial and ethnic minority grouping which includes refugees is weaker than that of their own
country. When it comes to whiteness, it usually symbolizes nurses or nursing as a profession.
Whiteness in nursing is widespread in today’s modern society, mainly because people believe
that being white one possesses superior skills and brilliant minds. Much statistical data shows
how whiteness has affected power dynamics in nursing. According to Cottingham, Johnson &
Erickson (2017), women of color in the nursing industry experience overworking.
It is appropriate that patients should be formally assessed to determine their readiness for
discontinuation of mechanical ventilation. This is because most damage is done during the
process of discontinuation of the process where nurses may take long and therefore exposing the
patient into possible risks. It is, therefore, the responsibility of the nurses in critical care
environments to ensure that the appropriate assessments are conducted daily to check evidence
that could be the underlying cause of respiratory failure to ensure that it has been reversed
(Rustam, Kongsuwan & Kitrungrote, 2018). Nurses, therefore, play a critical role in the
transitional stages of the patients from the moment they are transferred from the mechanical
ventilator which is very critical because of risk exposure. They must develop appropriate
strategies to monitor the patients closely and identify any changes in the physical conditions and

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support them psychologically during this period which is often very difficult and challenging for
them.
Evaluation
The project provides a useful framework for gaining the required skills and understanding
of the components and the various issues associated with mechanical ventilation. By the
completion of the with week project I will have achieved my goal of developing holistic nursing
care for patients with mechanical ventilation. This care is centered towards the understanding of
the risk conditions likely to be experienced by the patients during after mechanical ventilation
and the appropriate health care precautions or strategies to minimize the impact and reduce
further damage. The project will also provide a useful framework to analyze the various stress
factors and indicators in providing holistic nursing care that will be patient-focused and will help
improve health outcomes. In the end of the project I would therefore be equipped with necessary
skills to improve my services towards a holistic nursing healthcare. It is however necessary to
understand that it is my responsibility as a nurse to ensure that I’m acquainted with every skill
and knowledge that would be critical to helping patients with mechanical ventilation to achieve
the desirable healthcare outcomes.
The different journal reflections and books, as well as reviews, provide deep insights on
the nature of mechanical ventilation and the most critical aspects of care for patients with
mechanical ventilation. Most importantly it provides an outlook of the current measures taken
and their implication to nursing care. However, most of the literature review provides various
intervention strategies by nurses who are considered to be critical in improving healthcare
outcomes for patients with mechanical ventilation. These interventions include both the physical
interventions to complex technological and medical interventions and therefore it is the

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responsibility of the nurses to understand and equip themselves with the adequate knowledge and
skills on how best to handle different signs and symptoms as they reveal during and after the
mechanical ventilation process. By finishing the project, I will acquaint myself with these
interventions strategies and therefore be in a position to offer exceptional and holistic healthcare
towards improving healthcare outcomes for patients. I believe these skills and knowledge from
the project will be critical for my career growth and development.
Conclusion
From the above literature review, it is worth noting that the management of patients with
mechanical ventilator is very challenging for nurses and hence the need to develop holistic
nursing care towards improving their healthcare outcomes. One of the most critical issues is to
understand the various indicators that can be used for mechanical ventilation as well as
understanding the technical issues which can help in developing a patient-focused approach.
Understanding the importance of patient comfort needs is a critical element of holistic nursing
care and very essential to the patients healing process as well as helping them during the weaning
process from mechanical ventilation. The understanding of the critical nursing intervention
strategies towards patient centered care approach is critical to enhancement and provision of
quality healthcare as well as improve the healthcare outcomes of the patients. It is therefore the
responsibility of nurses to acquire the necessary skills and knowledge that will aid to the
development of effective intervention strategies. Developing nursing care strategies towards
these initiatives will contribute positively to the development of holistic nursing care and help
improve the health outcomes of patients with a mechanical ventilator.

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Barton, G., Vanderspank-Wright, B., & Shea, J. (2016). Optimizing oxygenation in the
mechanically ventilated patient: nursing practice implications. Critical Care Nursing
Clinics, 28(4), 425-435.
Brochard, L., Slutsky, A., & Pesenti, A. (2017). Mechanical ventilation to minimize progression
of lung injury in acute respiratory failure. American journal of respiratory and critical
care medicine, 195(4), 438-442.
Delgado, S. (2017). Manual of Critical Care Nursing: Nursing Interventions and Collaborative
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Faria, J. M. S., Pontífice-Sousa, P., & Gomes, M. J. P. (2018). Comfort care of the patient in
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