Background: "Persian Weaning Tool (PWT)" is the only specific, national protocol designed to assess patients' readiness for weaning from mechanical ventilation in Iran. This study was developed to determine the validity and reliability of this protocol.
Materials and Methods: This is a psychometric study conducted on 31 patients connected to mechanical ventilation were ready from weaning according to anesthesiologist's diagnosis and was selected through convenient sampling. The patients selected from Intensive Care Units (ICUs) of Al-Zahra Hospital in Isfahan. The sheet data collection includes demographic data, PWT; Burn's Wean Assessment Program (BWAP), and Morganroth's scale. To determine the inter-rater reliability between researcher and his partner, Pearson correlation and paired t-test were used. To assess the criterion validity of the PWT in relation to Burn's and Morganroth's weaning scales (as criteria), Pearson correlation and McNemar tests were used. To specify a minimum acceptable score of the PWT for weaning from mechanical ventilation, receiver operating characteristic curve was used.
Results: The results showed that there was statistically significant correlation between score of PWT and BWAP (r = 0.370 with P < 0.05) and there were no statistically significant differences between these tools in terms of identification of patients' readiness for weaning (P = 0.453). There was statistically significant correlation between PWT score obtained by researcher and his colleague (r = 0.928), and the reliability of this tool was approved. The PWTs cut of point was calculated as 57 (sensitivity = 0.679, specificity = 1).
Conclusions: The reliability and validity of the PWT were confirmed for this study's sample size. Consequently, the findings of this study can be used to measure the PWTs effectiveness and applicability in ICUs.
Danckers M, Grosu H, Jean R, Cruz RB, Fidellaga A, Han Q, et al. Nurse-driven, protocol-directed weaning from mechanical ventilation improves clinical outcomes and is well accepted by intensive care unit physicians. J Crit Care 2013;28:433-41.
Lavelle C, Dowling M. The factors which influence nurses when weaning patients from mechanical ventilation: Findings from a qualitative study. Intensive Crit Care Nurs 2011;27:244-52.
Irajpour A, Khodaee M, Yazdannik A, Abbasi S. Developing a readiness assessment tool for weaning patients under mechanical ventilation. Iran J Nurs Midwifery Res 2014;19:273-8.
Tonnelier JM, Prat G, Le Gal G, Gut-Gobert C, Renault A, Boles J, et al. Impact of a nurses′ protocol-directed weaning procedure on outcomes in patients undergoing mechanical ventilation for longer than 48 hours: A prospective cohort study with a matched historical control group. Br Med J 2005;9:83-9.
Yazdannik A, Salmani F, Irajpour A, Abbasi S. Application of Burn′s wean assessment program on the duration of mechanical ventilation among patients in intensive care units: A clinical trial. Iran J Nurs Midwifery Res 2012;17:520-3.
McLean SE, Jensen LA, Schroeder DG, Gibney NR, Skjodt NM. Improving adherence to a mechanical ventilation weaning protocol critically ill adults: Outcomes after an implementation program. Am J Crit Care 2006;15:299.
Morganroth ML, Morganroth JL, Nett LM, Petty TL. Criteria for weaning from prolonged mechanical ventilation. Arch Intern Med 1984;144:1012-6.
Mergoni M, Iacovelli W, Giovanelli L, Barantani D, Grattagliano C. Evaluation of traditional parameters and the Morganroth system to monitor the weaning process in patients treated with long-term mechanical ventilation. Minerva Anestesiol 1990;56:1265-7.