The Development of a Ventilator Weaning Model Conducted in the Surgical Ward of a Hospital Located in Kanchanaburi Province
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Abstract
Early weaning from mechanical ventilation reduces the risk of ventilator-associated pneumonia and promotes faster patient recovery. This research and development study aimed to examine the situation of mechanical ventilator use, to develop a ventilator weaning model, and to evaluate the outcomes of implementing the developed ventilator weaning model in a surgical ward. The study applied an evidence-based practice development approach guided by the Conduct and Utilization of Research in Nursing (CURN) framework. The participants consisted of two groups: 16 registered nurses and 88 critically ill surgical patients. The research instruments included a knowledge assessment questionnaire on mechanical ventilator weaning, a nursing practice assessment form related to the ventilator weaning process, and a ventilator weaning practice guideline (ASC2E2F bundle). The results revealed that in the male surgical ward, the highest proportion of successful ventilator weaning occurred within 1–7 days, accounting for 17 patients (26.20%). An equal number of patients (26.20%) experienced unsuccessful ventilator weaning. The developed ventilator weaning model comprised three components: assessment of patient readiness prior to ventilator weaning, assessment during the weaning process, and assessment of readiness prior to endotracheal tube removal. The developed ventilator weaning model for surgical patients emphasized nurse education and increased family participation in patient care. The outcomes were evaluated in 2 dimensions. 1) Regarding process outcomes, nurses demonstrated significantly higher knowledge of ventilator weaning guidelines after the training compared with before the intervention. 2) In terms of clinical outcomes, significant improvements were observed following implementation of the model, including reductions in ventilator-associated pneumonia, reintubation within 48 hours, and duration of ventilator weaning. In conclusion, the application of the ASC2E2F bundle ventilator weaning bundle effectively enhanced the quality of care and improved clinical outcomes among surgical patients undergoing mechanical ventilator weaning.
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บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
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