A systematic review of nurse-led weaning protocol for mechanically ventilated adult patients
Publication Type
Original research
Authors
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A systematic review of nurse-led weaning
protocol for mechanically ventilated
adult patients
Fatima Mohammad Hirzallah , Aidah Alkaissi and Maria do Céu Barbieri-Figueiredo
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 for mechanically
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. Pooleddatashoweda
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, I
2
=
18%, and p
=
0.00001); and hospital
length of stay (mean differences
=−
2.9 days, 95% confidence interval
=−
4.24 to
1.56, I
2
=
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
Journal
Title
© 2019 British Association of Critical Care Nurses
Publisher
Wiley
Publisher Country
British Indian Ocean Territory
Indexing
Thomson Reuters
Impact Factor
1.17
Publication Type
Prtinted only
Volume
--
Year
2019
Pages
1-8