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

November 5, 2008
November 5, 2008
December 2007
June 2008   (final data collection date for primary outcome measure)
Average Length of Stay on Ventilator [ Designated as safety issue: Yes ]
Same as current
No Changes Posted
  • 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 ]
Same as current
Not Provided
Not Provided
 
The Efficacy of Nurse-Driven, Protocol Guided Ventilator Weaning in a Medical-Surgical Intensive Care Unit (ICU)
The Efficacy of Nurse-Driven, Protocol Guided Ventilator Weaning in a Medical-Surgical ICU
  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.

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.

Observational
Observational Model: Cohort
Time Perspective: Prospective
Not Provided
Not Provided
Probability Sample

Mechanically Ventilated Patients in Medical-Surgical ICU

Vent Weaning in Medical- Surgical ICUs
Not Provided
1
Mechanically ventilated patients weaned by nurse-driven ventilator weaning protocol

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
215
June 2008
June 2008   (final data collection date for primary outcome measure)

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
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Not Provided
 
NCT00786617
07-122
Yes
Hassan Khouli, MD, St. Luke's Roosevelt Hospital
St. Luke's-Roosevelt Hospital Center
Not Provided
Principal Investigator: Hassan Khouli, MD St. Luke's-Roosevelt Hospital Center
St. Luke's-Roosevelt Hospital Center
September 2008

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP