Effect of ventilator bundle implementation on weaning indicator among mechanically ventilated patients at a selected private healthcare sector

Abstract

Background Mechanical ventilator (MV) has serious complications; thus, the ultimate goal of MV is ventilator discontinuation. Ventilator bundle is a group of practices aimed to improve the patient outcomes. Aim The aim of this study was to examine the effect of ventilator bundle implementation on weaning indicator among mechanically ventilated patients. Research design A quasiexperimental design was utilized. Sample A purposive sample of 60 mechanically ventilated patients was enrolled. Patients were matched for age, sex, and medical characteristics and then randomly assigned to two groups. The study group included patients for whom all elements of the ventilator bundle were applied completely, whereas the control group included patients for whom the ventilator bundle elements were not applied completely. Setting This study was conducted in the ICUs of a selected private hospital in Cairo. Tools of data collection Three tools were utilized: sociodemographic and medical data sheet, ventilator bundle compliance checklist, and Burns’ Wean Assessment Program checklist. Results There was a significant statistical difference between the compliant (study group) and the noncompliant (control) group as regards weaning indicator scores (t=4.20; P=0.001). There was a significant difference between patients of the two groups as regards the compliance with individual ventilator bundle elements with respect to head-of-bed elevation (χ2=4.85, P=0.046), sedation interruption (χ2=6.4, P=0.03), and assessment of readiness to extubate (χ2=5.2, P=0.02). Conclusion Implementation of ventilator bundle plays a pivotal role in weaning from a MV. Recommendation Applying the ventilator bundle practices with focusing on the head-of-bed elevation, daily sedation interruption, and assessment of readiness to extubate is highly recommended. Moreover, the use of a structured tool to assess readiness for weaning can help in managing the mechanically ventilated patients. Furthermore, replication of the study on a larger probability sample from different geographical locations in Egypt ensures generalizability of the study.