In this article published in McKnight’s Long-Term Care News, Mahlet Mitiku Desalegn, MD (Assistant Professor of Internal Medicine, St. Paul’s Hospital Millennium Medical College) discusses how the quality of care can be improved for mechanically ventilated patients.
Prolonged Mechanical Ventilation is a Patient Safety Issue
Dr. Desalegn first points out that prolonged mechanical ventilation is a patient safety issue, saying:
“According to one epidemiological study, approximately 310 people per 100,000 adults in the United States require invasive mechanical ventilation for non-surgical indications. Of those, quite a significant number of patients require prolonged mechanical ventilation support, which is defined by the Centers for Disease Control and Prevention as lasting more than 21 days for more than six hours a day.”
The Difficulty of Weaning Patients off of Mechanical Ventilation
Once a patient is on mechanical ventilation, it can be difficult to get that patient off of mechanical ventilation, as Dr. Desalegn emphasizes:
The great difficulty with mechanical ventilation is that once a patient is placed on mechanical ventilation, it can be difficult to wean or liberate that patient off of mechanical ventilation. Even if weaning is successful, many elderly patients will be left with variable degrees of disabilities and compromised quality of life … In addition, prolonged stay after intubation results in patient deconditioning, worsening of weakness from disuse, and emotional trauma. In a study of prior hospital stays and outcomes of ventilated patients in long-term acute care hospitals of 13,622 patients, researchers reported that the ventilation weaning rate was 51.7%. In addition, each additional day spent in the acute care hospital after endotracheal intubation reduced the odds of weaning.
The Need for a Standard of Care for Mechanically Ventilated Patients
This difficulty is compounded by the lack of universally accepted weaning protocols.
The Enhanced Respiratory Care Program from the Physician-Patient Alliance for Health & Safety provides that standard of care for mechanically ventilated patients.
To learn how your healthcare facility can be certified as meeting or exceeding the Standards of Care for mechanically ventilated patients, please click here.
To receive continuing medical education (CME) credits for learning how to apply the Standards of Care, please click here.
To read Dr. Desalegn’s article in McKnight’s Long-Term Care News, please click here.
Mahlet Mitiku Desalegn, M.D., is an assistant professor of Internal Medicine at St. Paul’s Hospital Millennium Medical College, and a volunteer with the Physician-Patient Alliance for Health & Safety.