Nursing Model for Weaning from Ventilators in Adults and the Elderly : A Systematic Review
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Abstract
This systematic review aimed to synthesize empirical evidence regarding nursing care models for ventilator weaning in adult and older adult patients. The review was conducted based on the Joanna Briggs Institute (JBI) methodology for systematic reviews. Studies published between 2015 and 2025 were searched from six electronic databases, including ScienceDirect, CINAHL, PubMed, EBSCO, SpringerLink, and ThaiJO. A total of 617 studies were identified. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 10 studies met the eligibility criteria and were included in the review. Data were analyzed using content synthesis.
The findings revealed that the ventilator weaning process could be categorized into three phases: pre-weaning, weaning, and post-weaning. In the pre-weaning phase, comprehensive assessment of patients’ physiological and clinical readiness enhanced the accuracy of identifying suitable candidates for ventilator weaning. During the weaning phase, techniques such as spontaneous breathing trials (SBT), pressure support ventilation (PSV), and cuff leak tests played significant roles in evaluating respiratory capacity and reducing the risk of weaning failure. In the post-weaning phase, continuous clinical monitoring combined with supportive care, particularly the use of high-flow nasal cannula (HFNC), contributed to reducing complications, lowering reintubation rates, and improving gas exchange efficiency.
In conclusion, an integrated nursing care model encompassing all three phases of ventilator weaning should be developed to enhance clinical effectiveness and patient safety among critically ill patients. Further research, particularly randomized controlled trials and long-term follow-up studies, is recommended to strengthen the evidence base and support the implementation of nursing practices in clinical settings.
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