Caring for Patients on

AJN t May 2005 t Vol. 105, No. 5 http://www.nursingcenter.com suspended because her gastric residual volumes have been greater than 100 mL per hour. She is lying flat in bed with a temperature of 103°F. Heavily sedated, she responds only to suctioning. What are the most important interventions to consider, and what are the best, evidence-based nursing practices to help Ms. Liston be liberated from the ventilator? This article addresses several integral areas of care, including weaning from mechanical ventilation, preventing ventilatorassociated pneumonia, providing nutritional support, managing anxiety, timing tracheostomy, preventing aspiration, and promoting sleep. (In this article, mechanical ventilation refers to the use of positive-pressure ventilators that deliver air invasively through endotracheal or tracheal tubes.) The longer a patient remains on mechanical ventilation, the greater the risk of complications, which increase the likelihood that the patient will require a longer hospital stay. Patients on mechanical ventilation are occupying beds not only in ICUs, where its use is typical, but also on intermediate care and step-down, medical–surgical, pulmonary rehabilitation, and long-term care units.