Critical care nurses' knowledge and attitudes toward using ventilator waveform monitoring to detect patient-ventilator asynchrony: A cross-sectional online survey

Abstract Background Most mechanically ventilated patients will be exposed to some asynchrony with the ventilator. Inability to detect and manage patient-ventilator asynchrony (PVA) as early as possible may lead to poor outcomes, including, but not limited to, prolonged mechanical ventilation, extended ICU stay, and higher mortality. Critical care nurses as primary health care providers may achieve significant participation in the timely detection of PVA. Waveform monitoring is a non-invasive and reliable method, but it is also regarded as a challenging task even for skilled clinicians. The aim of the study is to assess the knowledge level and attitude of critical care nurses in Egypt regarding the use of ventilator waveform monitoring to detect PVA. Methods A cross-sectional online survey was carried out in three intensive care units in three hospitals in Alexandria, Egypt. The questionnaire comprised four parts to evaluate critical care nurses' level of knowledge and attitude regarding ventilator waveform monitoring and assessed their ability to detect PVA. Results Most nurses (88.1%) have poor knowledge levels and negative attitudes (93.1%) toward using waveform monitoring to detect PVA. A significant relationship was found between nurses' knowledge of ventilator waveform monitoring and previous training programs on mechanical ventilation (P = 0.031). In addition, a significant relationship between nurses' attitude toward ventilator waveform monitoring and their level of education (P = 0.002), and their attendance in previous courses containing waveform analysis (P = 0.020) was noted. A highly significant relation (P = 0.000) was detected between nurses' level of knowledge and their attitude toward ventilator waveform monitoring. Conclusions The majority of the critical care nurses have poor knowledge and negative attitudes regarding using ventilator waveform monitoring to detect PVA. Previous training on mechanical ventilation and attendance of courses on ventilator waveform analysis was found to be significantly correlated with nurses' level of knowledge and attitude regarding ventilator waveform monitoring.