An evaluation of the impact of a tracheostomy weaning protocol on extubation time

• Published in: Nursing in critical care 2009-05, Vol.14 (3), p.131-138
• Main Authors: Clifford, Collette, Spencer, Alison
• Format: Article
• Language: English
• Subjects: Chi-Square Distribution; Clinical Nursing Research; Clinical Protocols - standards; Critical Care - methods; Critical Care - standards; Evidence-Based Practice; Extubation; Female; Guidelines; Humans; Male; Middle Aged; Nursing; Outreach; Patient Care Planning - standards; Pilot Projects; Prospective Studies; Protocol; Research Design; Retrospective Studies; Time Factors; Tracheostomy; Tracheostomy - adverse effects; Tracheostomy - nursing; Ventilator Weaning - methods; Ventilator Weaning - nursing; Ventilator Weaning - standards; Weaning
• ISSN: 1362-1017; 1478-5153
• DOI: 10.1111/j.1478-5153.2008.00325.x

Background:  To avoid the possible complications of prolonged intubation, it is necessary and advisable to attempt weaning from the tracheostomy tube at the earliest opportunity. However, while weaning protocols have proven successful in reducing ventilation time of critical care patients, there is little evidence of their use and impact on tracheostomy tube weaning time. Aims:  This pilot study sought to determine if the introduction of a new tracheostomy weaning protocol would reduce the time to extubation of the tracheostomy. Method:  A quasi‐experimental design used two groups of patients. A retrospective control group of patients (n = 20) who had been weaned using standard practice were identified by a search of medical records. A prospective experimental group (n = 20) had care planned using a new tracheostomy weaning protocol. Data relating to time to extubation were collected on both groups who were all patients in an eight‐bedded Critical Care Unit of a District General Hospital. The same inclusion and exclusion criteria were applied to both groups. Results:  The results revealed a reduction of 1·35 days from commencement of weaning to extubation in the prospective (experimental) group. This was not statistically significant (P = 0·181) Conclusion:  Although the findings from the study were not statistically significant, they can be seen as clinically significant in terms of patient comfort and reduced dependency in care by a reduction of time with a tracheostomy. It is recommended that a larger scale study be carried out to determine if a tracheostomy weaning protocol does make an impact on length of time to extubation in wider care settings.