Date on Paper

8-2022

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Kimberly Meyer

Committee Co-Chair (if applicable)

Elizabeth Burckardt

Author's Keywords

Mechanical ventilation, Quality improvement, Weaning protocol

Abstract

Background: Prolonged duration of mechanical ventilation (MV) is associated with higher morbidity, mortality, and increased resource utilization. Research has shown that the coordination of spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) through standardized protocols increases frequency of readiness to extubate assessments, thus reducing time on MV.

Purpose: The purpose of this project was to improve weaning protocol adherence by re-educating RN staff about the current weaning protocol and the importance of interdepartmental communication to perform coordinated SATs/SBTs, thus reducing MV duration.

Intervention: Education was provided to nursing staff on the current weaning protocol and the literature supporting the evidence-based practice aimed to create a coordinated effort between nursing and respiratory therapy departments to improve protocol compliance.

Measures: Processes measures in this project were the percentage of daily awakening trials and spontaneous breathing trials performed concurrently on eligible patients. Outcome measures included the total number of days patients required MV.

Results: There was no statistically significant relationship between the pre- and post-intervention group and SATs performed (p = .37), incidence of readiness to extubate assessments (p = 1), SBTs performed (p = .35), or coordinated SAT/SBTs (p = .37). The difference between Pre- and Post-intervention groups with respect to the dependent variable MV duration was statistically significant, U=22.5, p=.038, r= 0.47.

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