HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Take the CE Test Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grap, M. J. Articles by Sessler, C. N. Search for Related Content PubMed PubMed Citation Articles by Grap, M. J. Articles by Sessler, C. N.

Collaborative Practice: Development, Implementation, and Evaluation of a Weaning Protocol for Patients Receiving Mechanical Ventilation

• Background Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort.

• Objective To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from mechanical ventilation in a medical respiratory intensive care unit.

• Methods The weaning protocol used was a modification of a protocol developed by Ely et al. Modifications included a more aggressive approach in proceeding to the spontaneous breathing trial, inclusion of the Richmond Agitation-Sedation Scale, and documentation of the production of secretions.

• Results Implementation of the protocol significantly reduced the duration of mechanical ventilation as measured by 8-hour shifts and ventilator days. Although length of stay in the intensive care unit was not significantly reduced (P = .29), a continuing downward trend occurred, from a mean of 8.6 days before the protocol was implemented to 7.9 days during the last 6 months of data collection (P = .07).

• Conclusions The need to provide efficient care requires the collaboration of all disciplines involved in providing patients’ care. The weaning protocol introduced in this study demonstrates the benefits of using a collaborative team to identify best practices and implement them in a practice setting.

This article has been cited by other articles:

				T. Unoki, A. Serita, and M. J. Grap Automatic Tube Compensation During Weaning From Mechanical Ventilation: Evidence and Clinical Implications Crit. Care Nurse, August 1, 2008; 28(4): 34 - 42. [Full Text] [PDF]

				J-M. Boles, J. Bion, A. Connors, M. Herridge, B. Marsh, C. Melot, R. Pearl, H. Silverman, M. Stanchina, A. Vieillard-Baron, et al. Weaning from mechanical ventilation Eur. Respir. J., May 1, 2007; 29(5): 1033 - 1056. [Abstract] [Full Text] [PDF]

				K. McCauley and R. S. Irwin Changing the Work Environment in Intensive Care Units to Achieve Patient-Focused Care: The Time Has Come Am. J. Crit. Care., November 1, 2006; 15(6): 541 - 548. [Abstract] [Full Text] [PDF]

				K. McCauley and R. S. Irwin Changing the Work Environment in ICUs to Achieve Patient-Focused Care: The Time Has Come. Chest, November 1, 2006; 130(5): 1571 - 1578. [Abstract] [Full Text] [PDF]

				S. E. McLean, L. A. Jensen, D. G. Schroeder, N. R. T. Gibney, and N. M. Skjodt Improving Adherence to a Mechanical Ventilation Weaning Protocol for Critically Ill Adults: Outcomes After an Implementation Program Am. J. Crit. Care., May 1, 2006; 15(3): 299 - 309. [Abstract] [Full Text] [PDF]

				A K Simonds Streamlining weaning: protocols and weaning units Thorax, March 1, 2005; 60(3): 175 - 182. [Full Text] [PDF]

				J. A. Krishnan, D. Moore, C. Robeson, C. S. Rand, and H. E. Fessler A Prospective, Controlled Trial of a Protocol-based Strategy to Discontinue Mechanical Ventilation Am. J. Respir. Crit. Care Med., March 15, 2004; 169(6): 673 - 678. [Abstract] [Full Text] [PDF]