Development and Validation of the RCC Ventilator Weaning Assessment Checklist in Patients Who Are Ventilator-Dependent

Authors

  • Jung-Chen Lee Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University
  • Hsing-Mei Chen Department of Nursing, College of Medicine, National Cheng Kung University https://orcid.org/0000-0003-2520-8054

Keywords:

Ventilator weaning assessment checklist, ventilator-dependent, ventilator weaning, mechanical ventilation, respiratory failure

Abstract

Background: Although a number of clinical weaning profiles have been developed, they are not completely suitable since some items in the profiles are out of date and not used in our practice. Developing a weaning checklist that is applicable and suitable in our practice can help achieve better weaning outcomes. Purpose: The purpose of this study was to develop and validate a 26-item respiratory care unit (RCC) ventilator weaning assessment checklist for predicting successful weaning from ventilators in patients with respiratory failure. Methods: A retrospective descriptive research design was employed, including two steps. In step 1, a heterogeneous focus group was held with five experts to discuss and finalize the RCC ventilator weaning assessment checklist, which has three domains: physiological function, electrolyte balance, and respiratory function. The content validity index of the new checklist was then assessed. In step 2, a chart review was employed to collect data and test the criterion validity using the RCC ventilator weaning assessment checklist. A total of 180 medical records were reviewed. The patients were those with acute respiratory failure who were admitted to the RCC of a medical center in southern Taiwan between January 2011 and December 2012. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off point for predicting weaning success using the checklist. Sensitivity, specificity, and positive and negative predictive values were calculated. Results: The content validity index of the five experts was 74% to 97% for the 26 items and 90% for the total scale. The mean age of the 180 participants was 74.28 ± 13.29 years old. Of the 180 participants, 80 (44.4%) were successfully weaned. The ROC curve analysis showed that the cut-off point for the checklist score was 67%, and the area under the curve (AUC) was 0.874 ± 0.026 (p < .001), with a sensitivity of 88%, a specificity of 79%, a positive predictive value of 77%, and a negative predictive value of 89%. Patients who had a score of 67% or above were 4.1 times more likely to wean successfully than those with a score lower than 67%. Conclusions: The 26-item RCC ventilator weaning assessment checklist is a useful tool for predicting successful weaning from ventilators for patients with acute respiratory failure. Further validation of this tool with prospective studies is needed.

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Published

2019-08-07

Issue

Vol. 1 No. 1 (2019): January-April, 2019

Section

Research Articles

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