ABSTRACT
Objectives: The aim of this systematic review is to synthesize the current best evidence for the effectiveness of weaning protocols led by nurses compared with usual
physician-led care.
Background: Protocol-directed weaning has been shown to reduce the duration of mechanical ventilation. Studies have reported that a weaning protocol administered by nurses
leads to a reduction in the duration of mechanical ventilation and has a major effect on weaning outcomes. This can have especially positive consequences for critically ill patients.
Study design: Systematic review with meta-analysis.
Search strategy: The databases CINAHL, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched from as far back as the database allowed until
January 2016.
Inclusion and exclusion criteria: Searches were performed to identify the best available evidence including quantitative studies of nurse-led weaning protocols formechanically
ventilated adult patients. We excluded all studies of weaning protocols implemented by non-nurses and non-invasive mechanical ventilation and studies that addressed patient
populations younger than 18 years of age.
Results: The database searches resulted in retrieving 369 articles. Three eligible studies with a total of 532 patients were included in the final review. Pooled data showed a
statistically significant difference in favour of the nurse-led weaning protocol for reducing the duration of mechanical ventilation (mean differences=−1.69 days, 95% confidence
interval =−3.23 to 0.16), intensive care unit length of stay (mean differences=−2.04 days, 95% confidence interval=−2.57 to −1.52, I2 =18%, and p=0.00001); and hospital
length of stay (mean differences=−2.9 days, 95% confidence interval=−4.24 to −1.56, I2 =0%, and p=0.00001).
Conclusion: There is evidence that the use of nurse-led weaning protocols for mechanically ventilated adult patients has a positive impact on weaning outcomes and patient safety.
Relevance to clinical practice: This review provides evidence supporting intensive care unit nurses’ crucial role and abilities to lead weaning from mechanical ventilation.
Key words: Adult intensive care • Critical care nursing • Systematic review • Ventilator weaning • Weaning protocol

العنوان

Nursing in critical care

الناشر

Wiley Services

بلد الناشر

البرتغال

Indexing

Thomson Reuters

معامل التأثير

2,8

نوع المنشور

إلكتروني فقط

المجلد

24

السنة

1

الصفحات

89-95