Effective of use Clinical Nursing Practice guidelines for Weaning Mechanical Ventilator in Surgical Intensive Care Unit

Abstract

Background: Mechanical ventilator weaning in critically ill surgical patients requires systematic assessment to balance timely ventilator liberation against the risk of premature extubation and prolong ventilation. Conversely, delayed weaning increases the risk of ventilator-associated pneumonia (VAP) and prolongs the duration of mechanical ventilation and hospital stay. This quasi-experimental study aimed to evaluate the effects of a nursing practice guideline for ventilator weaning on the duration of mechanical ventilation, weaning time, and professional nurses' satisfaction. A total of 150 critically ill surgical patients admitted to the Surgical Intensive Care Unit at Udon Thani Hospital were enrolled and assigned to either a control group receiving routine nursing care (n = 75) or an intervention group receiving care based on the ventilator weaning nursing practice guideline (n = 75). Data were analyzed using descriptive statistics and the independent-samples t-test.

          Results: The intervention group had a mean age of 67.85 ± 13.40 years, with 52 males (69.3%) and 23 females (30.7%), while the control group had a mean age of 66.42 ± 12.15 years, comprising 49 males (65.3%) and 26 females (34.7%). Vascular surgery was the most common surgical procedure in both groups (46.7% in the intervention group and 44.0% in the control group). The mean duration of mechanical ventilation was significantly shorter in the intervention group than in the control group (46.80 ± 15.35 vs. 74.50 ± 22.10 hours, p < .001). Likewise, the mean weaning duration was significantly reduced in the intervention group compared with the control group (8.45 ± 3.12 vs. 15.20 ± 7.45 hours, p < .001). In the intervention group, 69.3% of patients were successfully weaned within the first 8 hours, and 98.6% achieved successful weaning within 24 hours, with no cases of reintubation observed. Professional nurses reported the highest level of satisfaction with the ventilator weaning nursing practice guideline (mean = 4.80, SD = 0.40), particularly regarding patient safety and ease of implementation.

          Conclusion: The nursing practice guideline for ventilator weaning effectively reduced the duration of mechanical ventilation and weaning time while improving professional nurses’ satisfaction. These findings support the implementation of the guideline as a standard nursing practice to promote timely, safe, and effective ventilator liberation for critically ill surgical patients in intensive care units.