The Development of Weaning Protocol for Critically Ill Patients Receiving Mechanical Ventilator at Chaiyaphum Hospital

  • Jutharat Bangsang Chaiyaphum Hospital
  • Somkhuan Pirunthong Chaiyaphum Hospital
  • Udomrat Niyomna Chaiyaphum Hospital
  • Nongyao Thamulras Chaiyaphum Hospital
  • Apinya Sattham Chaiyaphum Hospital
Keywords: clinical nursing practice guideline, weaning protocal form mechanical ventilator, critically ill patients

Abstract

This study aimed to developed and examine the effect of weaning protocal for critical ill patients receiving
mechanical ventilator and satisfaction of nurse in Intensive Care Unit (ICU.) at Chaiyaphum Hospital. This study was used Kemmis & McTaggart’s action research and focus on participants. The participants: 15 nurses included: head nurses and nurses who were working at intensive care unit. The participants were share idea and experience by focus interview, brainstorming meeting and reflection between October 2015-August 2017. Research methodology was used including 3 cycles of 4-phases implementation witch were planning, action, observation and reflection. The first cycle development showed that has not clinical nursing practice guideline and some of the healthcare personnel did not adequate knowledge and skill. The development of weaning protocol for critically ill patients receiving mechanical ventilator included : 1) readiness assessment for weaning patients receiving mechanical ventilator 2) observe during weaning period 3) symptoms before extubation and 4) extubation. The second cycle included: critically ill patients receiving mechanical ventilator were assessment to weaning ventilator after 24 hours, weaning period and extubation on daytime and critically ill patients were observe at intensive care unit 24 hours after extubation. The third cycle included: head nurse or incharge nurse were supervision, control and monitor for practice. Finding from the development of weaning protocol for 90 critically ill patients receiving mechanical ventilator showed that: 1) Patients were weaning mechanical ventilator success increased from 54% to 98.7%. 2) Patients were re-intubation tube decreased from 16% to 6%. 3) Incidence of ventilator associated pneumonia decreased from 10.2 : 1,000 Vent. Day to 3.4 : 1,000 Vent. Day. 4) The mean time to wean mechanical ventilator decreased from 8.5 hrs. to 2 hrs. 5) The average number days weaning mechanical ventilator decreased from 28.5 days to 18.5 days. and 6) Nurses in intensive care unit had their usual guideline 100% and very good satisfy 95.4%. Suggested that the clinical nursing practice guideline is recommended to practice and update guideline.

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Published
2020-12-29