A Comprehensive Extubation Protocol to Prevent Extubation Failure

Abstract

Purpose: The purpose of this project was to determine if the modified Burns Wean Assessment Program would be appropriate to establish in three of HonorHealth’s intensive care units.Background: Mechanical ventilation is a widely used therapy in intensive care units and the decision to extubate is based on many factors that can vary among facilities and providers. A multifactorial extubation protocol can assist providers in making this decision and help identify if patients are appropriate for extubation. The modified Burns Wean Assessment Program is one protocol that can effectively identify patients who are more likely to fail extubation. Methods: The modified Burns Wean Assessment Program was retrospectively applied to 54 patients who were extubated in three intensive care units during a two-month period. Their scores on the modified Burns Wean Assessment Program were analyzed respective to their extubation outcome to determine if higher scores on the assessment were associated with extubation success and lower scores associated with extubation failure. Results: There were three extubation failures during the study period. The mean difference between the modified Burns Wean Assessment Program score in the extubation success and failure groups was not statistically significant. Conclusion: Due to a small extubation failure rate, the modified Burns Wean Assessment Program score did not show a statistically significant difference differentiating between extubation successes and failures. An opportunity exists for a larger study for facilities with more extubation failures to evaluate the use of the modified Burns Wean Assessment to improve extubation outcomes.