The Efficacy of Nurse-Driven, Protocol Guided Ventilator Weaning in a Medical-Surgical Intensive Care Unit (ICU)

This study has been completed.
Sponsor:
Information provided by:
St. Luke's-Roosevelt Hospital Center
ClinicalTrials.gov Identifier:
NCT00786617
First received: November 5, 2008
Last updated: NA
Last verified: September 2008
History: No changes posted
  Purpose
  1. Mechanically ventilated patients weaned by nurse-driven ventilator weaning protocol will have a mean length of stay on ventilator at least one day shorter than patients weaned by physician-initiated, non-protocol methods
  2. Mechanically ventilated patients weaned by nurse-driven ventilator weaning protocol will have al least similar Ventilator, ICU, and Hospital Length Of Stay (LOS) compared to patients weaned by physician-initiated, non-protocol method
  3. Nurse-driven ventilator weaning protocol is well accepted by other services: physicians, nurses, and respiratory therapists.

Condition
Vent Weaning in Medical- Surgical ICUs

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: The Efficacy of Nurse-Driven, Protocol Guided Ventilator Weaning in a Medical-Surgical ICU

Further study details as provided by St. Luke's-Roosevelt Hospital Center:

Primary Outcome Measures:
  • Average Length of Stay on Ventilator [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • ICU mortality [ Designated as safety issue: No ]
  • Hospital mortality [ Designated as safety issue: No ]
  • Treatment intensity and resource allocation: Cost of ICU care per year [ Designated as safety issue: No ]
  • Level of acceptance of nurse-driven vent weaning protocol [ Designated as safety issue: No ]

Enrollment: 215
Study Start Date: December 2007
Study Completion Date: June 2008
Primary Completion Date: June 2008 (Final data collection date for primary outcome measure)
Groups/Cohorts
1
Mechanically ventilated patients weaned by nurse-driven ventilator weaning protocol

Detailed Description:

Ventilatory support is one of the most common indications for admission to ICU (1).

The duration of mechanical ventilation is associated with several serious complications, increase mortality, prolong ICU stay, and increase hospital cost (7,8).

Traditionally, the process of ventilator weaning is initiated and carried out my physicians.

Recently, there have been few studies that supported the utility of protocol guided weaning algorithms. Its use have been associated with earlier initiation of weaning, leading to shorter ventilator time, and a trend for shorter ICU length-of-stay and lower hospital costs (1,2,4,9) Several studies have also shown the relative safety of utilizing nursing (3) and RT staff alone or in cooperation with medical staff in the weaning of patients from mechanical ventilation (1,2,6).

We recently developed a nurse-driven ventilator weaning protocol for all ICUs at St. Luke's and Roosevelt hospitals. The protocol was approved by the Critical Care Committee and is implemented as of May 2007. All ICU nurses, respiratory therapists, and ICU physicians have been educated on this protocol We plan to prospectively collect data to look at length of stay on mechanical ventilation in patients weaned by nurse-driven ventilator weaning protocol. We plan to compare such data to retrospectively collected ventilator LOS data in patients weaned by physician-initiated ventilator weaning method.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Mechanically Ventilated Patients in Medical-Surgical ICU

Criteria

Inclusion Criteria:

  • Receiving MV for at least 24 hours in the ICU
  • Meeting established protocol criteria for a vent wean trial

Exclusion Criteria:

  • Patients in whom MV was actively withdrawn for terminal wean
  • Brain dead patients on MV
  • Age <18 years old
  • Transfers from other hospitals or health care facility who were ventilator dependent
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00786617

Sponsors and Collaborators
St. Luke's-Roosevelt Hospital Center
Investigators
Principal Investigator: Hassan Khouli, MD St. Luke's-Roosevelt Hospital Center
  More Information

Publications:

Responsible Party: Hassan Khouli, MD, St. Luke's Roosevelt Hospital
ClinicalTrials.gov Identifier: NCT00786617     History of Changes
Other Study ID Numbers: 07-122
Study First Received: November 5, 2008
Last Updated: November 5, 2008
Health Authority: United States: Institutional Review Board

ClinicalTrials.gov processed this record on October 29, 2014