A systematic review of nurse-led weaning
protocol for mechanically ventilated
Fatima Mohammad Hirzallah , Aidah Alkaissi and Maria do Céu Barbieri-Figueiredo
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
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.
Systematic review with meta-analysis.
The databases CINAHL, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched from as far back as the database allowed until
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.
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
3.23 to 0.16), intensive care unit length of stay (mean differences
2.04 days, 95% conﬁdence interval
18%, and p
0.00001); and hospital
length of stay (mean differences
2.9 days, 95% conﬁdence interval
0%, and p
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.
Adult intensive care
Critical care nursing