Thesis defense Jérôme Dauvergne

Equipe

Team II - Ion channels and cardiopathies

Directeur de thèse

Co-Encadrant

Karim Lakhal

Rapporteurs

Yoann LAUNEY, MD, PhD, PUPH, Université de Rennes
Judith LEBLANC, PhD, MCU, Sorbonne Université, Paris

Examinateurs

Abstract

The use of evidence-based data from research in nursing practice is recommended by the World Health Organization. It is one of the three pillars of Evidence-Based Nursing Practice (EBN). Therefore, it is essential to have such data available for most nursing care procedures, ideally adapted to the French context. The objective of this thesis was to generate evidence for common intensive care nursing practices for which data were lacking, thereby limiting decision-making according to the EBN model. Studies were conducted for this purpose, focusing on: (1) the accuracy of blood pressure (BP) measurement at the ankle when placement of the cuff on the arm is not possible; (2) the evaluation of clot formation risk in the flush solution during blood sampling via an arterial catheter; and (3) the comparison of different endotracheal tube fixation devices. The results showed that patient positioning significantly affects the accuracy of BP measurement at the ankle. During arterial catheter blood sampling, the decrease in coagulation parameters over time suggested the initiation of clot formation. A confirmatory study is ongoing. Finally, the fixation devices for endotracheal tubes showed varying levels of effectiveness in preventing unplanned extubation, with some appearing unsuitable for continued use. These findings highlight the importance of intensive care nursing research in improving clinical practices—especially routine care—for the direct benefit of patients

Keywords: Evidence-based nursing, clinical decision, evidence, nursing care, intensive care unit, critical care nurse, blood pressure, blood sampling, arterial catheter, endotracheal tube, securing device