Clinical indicators of ineffective airway clearance in children with congenital heart disease

Author
da Silva, Viviane Martins · de Oliveira Lopes, Marcos Venícios · de Araujo, Thelma Leite · Ciol, Marcia Aparecida · de Carvalho, Emília Campos
Published March 2009
Journal Journal of Clinical Nursing
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Abstract

Aims and objectives. 

To analyse the sensitivity and specificity of clinical indicators of ineffective airway clearance in children with congenital heart disease and to identify the indicators that have high predictive power. Background. 

The precise establishment of nursing diagnoses has been found to be one of the factors contributing to higher quality of care and cost reduction in healthcare institutions. The use of indicators to diagnose ineffective airway clearance could improve care of children with congenital heart disease. Design. 

Longitudinal study. Methods. 

Participants consisted of 45 children, ≤1 year of age, with congenital heart disease, who had not had definitive or palliative surgical correction. Six assessments were made at 2-day intervals. Each clinical indicator was defined based on previously established operational criteria. Sensitivity, specificity and positive and negative predictive values of each indicator were calculated based on a model for the longitudinal data. Results. 

A nursing diagnosis of ineffective airway clearance was made in 31% of patients on the first assessment, rising to 71% on the last assessment, for a 40% increase. Sensitivity was highest for Changes in Respiratory Rates/Rhythms (0·99), followed by Adventitious Breath Sounds (0·97), Sputum Production (0·85) and Restlessness (0·53). Specificity was higher for Sputum Production (0·92), followed by Restlessness (0·73), Adventitious Breath Sounds (0·70) and Changes in Respiratory Rates/Rhythms (0·17). The best positive predictive values occurred for Sputum Production (0·93) and Adventitious Breath Sounds (0·80). Conclusions. 

Adventitious Breath Sounds followed by Sputum Production were the indicators that had the best overall sensitivity and specificity as well as the highest positive predictive values. Relevance to clinical practice. 

The use of simple indicators in nursing diagnoses can improve identification of ineffective airway clearance in children with congenital heart disease, thus leading to early treatment of the problem and better care for these children.

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Details

Title
Clinical indicators of ineffective airway clearance in children with congenital heart disease
Author
da Silva, Viviane Martins · de Oliveira Lopes, Marcos Venícios · de Araujo, Thelma Leite · Ciol, Marcia Aparecida · de Carvalho, Emília Campos
Year
2009
Journal
Journal of Clinical Nursing
Document Type
Research article
Language*
eng
Subjects
Assessment · Children · Clinical Judgement · Congenital Heart Disease · Critical Thinking · Nursing Diagnosis

Fields edited by Q-Sensei or Q-Sensei's users are marked with an asterisk (*).
This is Version 3 of this record. Q-Sensei Corp. added this version on November 3, 2009. It is an edited version of the original data import from IngentaConnect.com. View changes to the previous version or view the complete version history.