Caring for patients receiving long-term mechanical ventilation in an ICU poses many problems. In an effort to minimize these problems, a tertiary care center used collaboration as a model to develop a pulmonary step-down unit with a multidisciplinary weaning program. A nurse practitioner manages the patients and coordinates the multidisciplinary team. A case presentation illustrates how collaboration is used on a daily basis to operationalize the weaning program.

Approximately 1.5 million persons receive mechanical ventilation annually in the United States.1 Of these, up to 25% require prolonged mechanical ventilation,2 which is defined as 3 days or more of continuous mechanical ventilation.3 Patients who require prolonged mechanical ventilation are often 60 years or older and have 1 or more comorbid conditions.4 Such patients frequently require gradual withdrawal of ventilatory support (ie, weaning),2,5,6 which...

You do not currently have access to this content.