This study spanned more than 5 years in 5 adult intensive care units (ICUs) targeting use of a weaning assessment program for mechanically ventilated patients. The Burns Wean Assessment Program (BWAP) is a 26-item checklist that can be used to promote consistent management of patients receiving mechanical ventilation. The instrument had been tested previously in medical ICU patients and the current study extended use to surgical, neurological, thoracic-cardiovascular, and coronary ICUs.

Using the BWAP, advanced practice nurses screened patients within 24 hours of a weaning attempt in conjunction with use of a multidisciplinary pathway and protocols for weaning and sedation guidelines. Of 1869 weaning attempts, 1669 (88%) were successful and 220 (12%) were unsuccessful. The study showed that regardless of the ICU unit, patients with BWAP scores greater than 50 were significantly more likely to be weaned successfully than were patients with lower scores.

Suzanne M. Burns, RN, MSN, RRT,...

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