Team-Based Care of the Patient Receiving Venovenous Extracorporeal Membrane Oxygenation

Abstract

Background: Guideline-based care of patients requiring extracorporeal membranous oxygenation, a form of life support for patients with refractory respiratory and/or cardiac failure, requires a multidisciplinary approach, yet a detailed description of the ideal integration of teams of physicians, acute care nurse practitioners, critical care nurses, and other disciplines is lacking in the literature.

Objectives: We sought to define team-based care of the patient receiving venovenous extracorporeal membrane oxygenation with an emphasis on the roles of the critical care nurse and the acute care nurse practitioner.

Methods: A narrative literature review was conducted using the keywords or MeSH terms "team-based care" AND "ECMO" and "nurse practitioner" AND "ECMO." Electronic databases searched included PubMed, Cumulative Index for Nursing and Allied Health Literature, and PsycINFO.

Results: Sixty-five articles met the search criteria, with 21% (n = 10) focusing on characteristics of team-based care for patients receiving ECMO. Articles describe the ideal composition of teams and their education and training, frameworks for the formation of ECMO teams, and aspects of communication. One article details the role of the acute care nurse practitioner in managing ECMO, but several omit or barely describe the nurse's role as a team member.

Discussion: No articles were found that specifically define the key elements, structure, and dynamics of effective team-based care of the patient receiving ECMO. A holistic definition of team-based care of the patient receiving ECMO is proposed. Further research is warranted to correlate aspects of team-based care that optimize patient, team, and organization outcomes.