Publication Date

Spring 2026

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Alice Butzlaff

Keywords

ICU liberation, Spontaneous awakening trials

Abstract

Spontaneous Awakening and Breathing Trials (SAT/SBT) might be central to early extubation by decreasing total ventilator time and reducing the intensive care unit (ICU) length of stay (LOS). Unfortunately, these trials often have not been conducted consistently in the ICU. The purpose of this research was to evaluate the frequency of SAT/SBT performed prior to mechanical ventilator extubation on total ventilator time in hours and LOS. Quality improvement aims were: (1) to ascertain if an extubation readiness tool could be easily followed and documented, and (2) to evaluate if an extubation readiness tool would add value in clinical practice. A retrospective chart review was conducted between December 2024 – July 2025 on two cohorts of mechanically ventilated adults (N = 109). SAT/SBT pre- and post- documentation education was collected in addition to time from trials to extubation or reintubation, ICU LOS and total ventilator time in hours. Analyses of data included descriptive statistics, two sample independent t- tests and chi-square. The frequency of documented SAT/SBT improved over time. However, the frequency of SAT/SBT was not significantly related to the ICU patient’s total ventilator time in hours (p = .44) or for the ICU LOS (p = .52). ICU patients who did meet all extubation readiness criteria were shown to be statistically significant with successful ventilator tube removal (X2 (1, N = 88) = 24.53, p < 0.001). Findings suggest that extubation readiness criteria would be a worthwhile tool for predicting successful ventilator tube removal that could enhance ICU liberation.

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