Interdisciplinary Strategies for Enhancing the Management of Invasive Mechanical Ventilation in Critical Care: The Integral Roles of Nursing and Respiratory Therapy

Abstract

Background: Invasive mechanical ventilation (IMV) is a fundamental intervention for patients in critical care, yet its application often varies due to the complex interplay of patient pathology, lung mechanics, and clinician decision-making. Personalized ventilation strategies are essential to mitigate the risks of morbidity and mortality associated with improper ventilatory management.

Methods: This narrative review synthesizes the existing literature on interdisciplinary approaches to managing IMV, focusing on the roles of nursing and respiratory therapy. A comprehensive search of MEDLINE and EMBASE databases was conducted for peer-reviewed articles published in English up to 2023, systematically extracting data pertaining to clinical decision-making processes, role delineation, and the deployment of Clinical Decision Support Systems (CDSS).

Results: The findings reveal significant variability in decision-making responsibilities among healthcare professionals, with nurses often guiding assessments related to weaning readiness, while physicians predominantly oversee initial ventilator settings and extubation. The integration of CDSS into clinical practice shows promise in optimizing ventilation strategies, yet barriers to implementation, such as clinician resistance and workflow disruptions, persist.

Conclusion: Enhancing interdisciplinary collaboration and the effective deployment of CDSS are critical for improving patient outcomes in mechanical ventilation management. Future research should focus on clarifying decision-making determinants and refining implementation strategies to facilitate the adoption of best practices in critical care settings.