Implementing a protocol for weaning patients off mechanical ventilation.

Weaning patients from ventilation can be a costly and time-consuming intervention. This article describes how a protocol was designed and introduced into the critical care unit of a district general hospital in 2003. A step-by-step approach was used based on that outlined by the Modernisation Agency and The National Institute for Clinical Excellence. The purpose of the project was to improve the weaning process in the unit by devising a protocol, which would give structure to weaning and help maintain continuity. It was hoped that the changes in practice would also reduce ventilator time and improve patient outcomes. A multi-professional group interested in weaning worked together to formulate a protocol, which was duly implemented into the unit. After implementation, the protocol was audited and subsequently adopted by the unit. Although it was agreed that the structure and the continuity of weaning had improved, reducing weaning times and patient outcomes was difficult to measure. This article explains how the protocol came to be written and how it was implemented into the unit.