ประสิทธิผลการใช้แนวปฏิบัติการพยาบาลในการหย่าเครื่องช่วยหายใจต่อความสำเร็จ ระยะเวลาการใช้เครื่องช่วยหายใจ และจำนวนวันนอนในหอผู้ป่วยหนักศัลยกรรมและศัลยกรรมอุบัติเหตุ โรงพยาบาลลำพูน

Sopha  Panyoyai; Pornthana  Kaewkhumpa; Yupparet  Kawee; Sangaroon Suksumran

Authors

Sopha Panyoyai Lamphun Hospital, Lamphun Province
Pornthana Kaewkhumpa Lamphun Hospital, Lamphun Province
Yupparet Kawee Lamphun Hospital, Lamphun Province
Sangaroon Suksumran -

Abstract

Introduction: Effectiveness of Nursing Practice Guidelines for Mechanical Ventilation Weaning can reduce the duration of mechanical ventilation and length of stay.

Objective:This study aims to effectiveness of nursing practice guidelines for mechanical ventilation weaning on weaning success, mechanical ventilation duration, and length of stay in surgical and trauma intensive care units.

Methodology: This study a quasi-experimental design with two groups and post-test measurements. The study sample consisted of two groups: 21 registered nurses and critical surgical patients on ventilators who were purposively sampled and placed in control and experimental groups of 35 subjects each. The research instruments: Nursing Practice Guidelines for Mechanical Ventilation Weaning; a personal data record form; the outcome data collection form; a feasibility assessment form for implementing the nursing practices guidelines; and the satisfaction assessment form. The instruments were tested for content validity, yielding a value of 1.0, As for reliability, the instruments obtained a Cronbach’s alpha coefficient of 0.80-0.89. Data were analyzed using
chi-square testing and the Mann-Whitney U Test.

Results: According to the findings: 1) successful weaning from ventilators was significantly higher in the group for which ventilator-weaning guidelines were implemented than the control group (p< .001); 2) ventilator-weaning time in the experimental group was significantly shorter than the control group (p< .001); and 3) length of hospitalization, particularly in the surgical intensive care unit, was significantly shorter in the experimental group than the control group (p< .001).

Conclusion: The implementation of the nursing practice guidelines for ventilator weaning resulted in a higher success rate of ventilator weaning, shorter duration of mechanical ventilator, and length of stay

References

Wisettiphan T, Pukkham K, Yodrabum S. Development of a model for weaning mechanical ventilation in surgical critically ill patients, Maharaj Nakhon Si Thammarat Hospital. Thai J Cardio Thorac Nurs. 2019;30(2):176–92. (In Thai).

Burns KEA, Rizvi L, Cook DJ, Dodek P, Slutsky AS, Jones A, et al. Variation in the practice of discontinuing mechanical ventilation in critically ill adults: study protocol for an international prospective observational study. BMJ Open. 2019;9(9):e031775.

Wongkharmphan W.Effect of using a weaning protocol in intensive care unit patients, Somdejphra Yupparaj Detudom Hospital. J Health Sci Boromarajonani Coll Nurs Sanpasit thiprasong. 2019;3(2):56–71. (In Thai).

Learahabumrung P, Saisit W, Pimdee Y, Sukhong R, Rattanahongsa N,& Rattanakunuprakarn U. Effect of developing a clinical practice guideline for weaning mechanical ventilation in patients with brain injury, Nakhon Pathom Hospital. Christian Univ Nurs J. 2025;12(1). (In Thai).

Chiaranai C, Benjarak A, Kingsanthia K, & Prommart S, Nursing care for critically ill patients on mechanical ventilation: self-care theory and application of nursing system theory. J Health Educ Nurs. 2022;28(1). (In Thai).

Wannakul A. Development of Clinical Practice Guideline for Weaning Protocol from Mechanical Ventilator in SICU Phatthalung Hospital. Kb. Med. J.2018;1(2):13-24. (In Thai).

Blackwood B, Alderdice F, Burns K, Cardwell C, Lavery G, O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ. 2011;342:c7237.

Winthai A, Sukontawat W. Effectiveness of applying a weaning protocol for mechanically ventilated multi-trauma patients in Surgical ICU 1, Udonthani Hospital. J Nurs Health Educ. 2023;6(2):61–73. (In Thai).

Burns SM, editor. AACN protocols for practice: care of mechanically ventilated patients. 2nd ed. Sudbury (MA): Jones & Bartlett Publishers; 2006.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2) :175–191.

Eamlaor S, & Sunthornsatean P. Development of a clinical nursing practice guideline for weaning protocol from mechanical ventilation in Patient Admitted to Intensive Care Unit, Banpong Hospital, Ratchaburi Province. Reg Med J 4–5. 2023;42(2):277–91. (In Thai).

Thammakijpirote K, Jeamtim N, & Maneewong J. Weaning mechanical ventilation in medical critically ill patients: a systematic review. J Health Promot Qual Life. 2024;4(3):111–23.(In Thai).

Blackwood B, Alderdice F, Burns K, Cardwell C, Lavery G, O’Halloran P. Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ. 2011;342:c7237. doi:10.1136/bmj.c7237

Jhou HJ, Chen PH, Ou-Yang LJ, Lin C, Tang SE, Lee CH. Methods of weaning from mechanical ventilation in adult: A network meta-analysis. Front Med (Lausanne). 2021;8:752984. doi:10.3389/fmed.2021.752984

Shehab MS, Saadoon MM, Nasser HM, Fathy AM. Nurses performance about safety weaning from mechanical ventilation of critically ill adults and children. Int J Nurs Didactics. 2018;8(11):11–16. doi:10.15520/ijnd.v8i11.2519

Learahabumrung P, Saisit W, Pimdee Y, Sukhong R, Rattanahongsa N, & Rattanakunuprakarn U. Effects of Development of Clinical Practice Guidelines for Weaning of Mechanical Ventilation amongPatients with Brain Injury, Nakhon Pathom Hospital. Journal of Nursing Science Christian University of Thailand 2025; 12 (1).