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- Title
Pulmonary Critical Care. MULTIFACTOR CLINICAL SCORE AND OUTCOME OF MECHANICAL VENTILATION WEANING TRIALS: BURNS WEAN ASSESSMENT PROGRAM.
- Authors
Burns, Suzanne M.; Fisher, Charles; Tribble, Sidenia S. (Earven); Lewis, Rose; Merrel, Paul; Conaway, Mark R.; Bleck, Thomas P.
- Abstract
Background: The Burns Wean Assessment Program is a 26- factor weaning assessment worksheet and scoring instrument used to reduce practice variability in the clinical management of patients receiving mechanical ventilation. The instrument has been tested in patients in a medical-surgical intensive care unit, but further testing in different populations of adult patients is needed. Objectives: To determine the relationship between Burns Wean Assessment Program scores and outcomes of weaning trials in patients treated with mechanical ventilation for 3 or more days. Methods: For 5 years in 5 adult critical care units (surgical, medical, neurological, thoracic-cardiovascular, and coronary care), advanced practice nurses collected scores within 24 hours of a weaning attempt. All patients were managed similarly by using a multidisciplinary pathway, the Burns Wean Assessment Program checklist, protocols for weaning trials, and sedation guidelines. Results: Of 1889 weaning attempts, 1669 (88%) were successful, and 220 (12%) were unsuccessful. Weaning outcomes did not differ according to sex, but significantly more trials were successful in younger patients than in older patients (P = .002) and in patients in different units (P = .01). Regardless of unit, patients with Burns Wean Assessment Program scores greater than 50 were significantly more likely to be weaned successfully (P = .001) than were patients with lower scores. Conclusions: Systematic tracking of the factors and scores on the Burns Wean Assessment Program may be helpful in care planning and management and in determining weaning potential.
- Subjects
ANALYSIS of variance; CONFIDENCE intervals; CRITICAL care medicine; CRITICALLY ill; DATABASES; LISTS; LONGITUDINAL method; RESEARCH methodology; EVALUATION of medical care; MEDICAL education; NURSES; NURSING specialties; PATIENTS; STATISTICAL sampling; MECHANICAL ventilators; LOGISTIC regression analysis; DATA analysis; CONTINUING education units; RECEIVER operating characteristic curves; DIAGNOSIS; EVALUATION
- Publication
American Journal of Critical Care, 2010, Vol 19, Issue 5, p431
- ISSN
1062-3264
- Publication type
Article
- DOI
10.4037/ajcc2010273