Effect of clustered nursing interventions on physiological responses in critically ill patients

Background Caring of the critically ill patients is a fundamental component of a nurse’s clinical practice in ICUs. Clustered nursing interventions are defined as a group of interventions of more than six for each patient in one nursing interaction. Physiological responses may be an immediate response or long-term effects of one or more of the body systems related to physiological condition and therapeutic interventions. Critical care nurses monitor physiologic patient parameters on a regular basis to ensure patient’s stability. Objective The aim was to determine physiological responses related to clustered nursing interventions among critically ill patients. Participants and methods The study was conducted on 80 mechanically ventilated adult patients admitted to ICUs of Alexandria Main University Hospital and Damanhour Medical National Institute. The most common procedures provided by nurses in direct care for those patients based on a pilot study of 10 patients were vital signs measurements, central venous pressure measurement, suctioning, feeding, laboratory sampling, general care, repositioning, and administration of medications. Physiological parameters measured were end-tidal carbon dioxide using capnography, vital signs using bed side monitor, and oxygen saturation using pulse oximeter. They were measured before, at 5 min and 10 min during clustered nursing interventions, immediately after, and 15 min after clustered nursing intervention performance. Results Respiratory rate, systolic blood pressure, and oxygen saturation were significantly changed in relation to clustered nursing interventions. Conclusion Clustered nursing interventions may worsen some physiological parameters in critically ill patients, and therefore, nonclustered interventions should be applied instead. Moreover, continuous monitoring of physiological responses during nursing care is crucial.