A Comparison of Weaning Success Rate between Conventional and New Weaning Nursing Practice Guidelines in Patients Receiving an Invasive Mechanical Ventilator at Chaophrayayommarat Hospital
Keywords:
Guidelines for weaning from ventilators, Ventilator, Successful weaning from ventilatorsAbstract
This action research aims to: 1) develop the weaning guideline based on empirical evidence; and 2) study the effect of adopting of the standard and new-developed weaning guideline on successful rate of ventilator weaning. The research was divided into two phases: phase 1: the development of the guideline using the evidence-based conceptual development framework of Rosswurm & Larrabee, phase 2: implementation between December 2022 and January 2023. The content validity index examined by five experts was 0.98, and then the quality determined by five experts using the AGREE II tool, showed the overall quality as of 76.67%. The sample were 120 patients being on a ventilator for more than 24 hours, divided into control and experimental groups, 60 cases per group. The instruments consist of the new ventilation weaning guideline developed by the researcher, the patient's information record form, and the guideline implementation data record form. The data were analyzed using descriptive statistics, Chi-square statistics, Logistic regression and independent sample t-test.
The results showed that there were no difference in age, sex, diagnosis, and causes of respiratory failure in the two groups of samples (p>.05). Compared to the standard guideline, the weaning successful rate in the experimental group using the new ventilator was statistically significantly higher (p<. 001) with higher possibility to be able to wean-off the ventilator 4.50 times (95%CI=1.66-12.23) higher. Moreover, the duration of ventilator use and the length of stay in the ward were reduced compared to the conventional method (p<.001). The findings of the study pointed out that the new weaning nursing practice guidelines that have been developed are of good quality and can be implemented and should be adopted to specific and critical group of patients or further study in different age group.
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