VALIDATION OF A WEANING SCORE INSTRUMENT (VENTILATOR, RESPIRATOR, MECHANICAL VENTILATION).
Contributors: Southern Illinois University at Edwardsville.
Published: 1991
Number of pages: 71
Subjects: Health Sciences, Education.; Health Sciences, Nursing.; Health Sciences, Medicine and Surgery.
Description: The purpose of this study was to identify and categorize factors, from a Weaning Score Instrument (WSI), which impeded or promoted clinical decision making in determining when to wean a patient from mechanical ventilation.

The WSI was a twenty-eight item, sixty point instrument that was used to assess the patient's physiological and behavioral (PPBB) and ventilatory (VVV) variables to aid in determining a readiness to wean from mechanical ventilation. Pilot testing of the WSI in the Fall of 1987 concluded that the instrument was reliable (inter-rater reliability 0.93 and test-retest reliability 0.92) and had a strong content validity (CVI = 0.88).

Two hypotheses were tested. The first hypothesis investigated the degree of difference in the average weaning score for patients who successfully weaned from the ventilator as compared to those who did not. The point biserial correlation (r(bis) = 0.24, p = 0.0005) showed that the average weaning score (twenty-six points (43 percent)) for those who successfully weaned from the mechanical ventilator was statistically significantly lower when compared with the group that did not wean.

The second hypothesis investigated the optimal range for weaning for each group studied (MICU, SICU, and CVR). The optimal range for weaning these three groups was the score of twenty-six points or lower. ANOVA ((PPBB) F = 13.813, p.0001 and (VVV) F = 9.24, p.0001) with a post-hoc Scheffe' test determined that the most significant pair-wise comparisons occurred between the MICU and CVR and MICU and SICU populations. Also more patients successfully weaned from the mechanical ventilator in the MICU population. ANOVA determined that there was no significant difference in successful weaning between the subjects who were over forty and those who were under forty.

Secondary analyses used factor analysis, ANOVA, and t-test to identify fourteen significant variables. Discriminant analysis determined that the WSI correctly identified patient's readiness to wean 84 percent of the time for physiological and behavioral variables and 74 percent of the time for ventilatory variables.

These data imply that the WSI has the potential to assist in determining a patient's readiness to wean, and there are fourteen critical variables that the nurse can use to assess this readiness.
Notes: Source: Dissertation Abstracts International, Volume: 52-04, Section: B, page: 1937.

Thesis (ED.D.)--SOUTHERN ILLINOIS UNIVERSITY AT EDWARDSVILLE, 1991.

School code: 0509.