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org/journal-pulmonology-clinical-research/

Nurses’ knowledge regarding weaning criteria of the patients with mechanical

ventilation in a teaching hospital, Chitwan.
Pradhan C1, Shrestha R2*
1
Bal Kumari College, Bharatpur, Nepal
2
Chitwan Medical College, Bharatpur, Nepal

Abstract
Introduction: Ventilator weaning is the process of gradually withdrawing artificial ventilation
to the intubated patients for short or long time in critical care setting. Weaning patients from
ventilator is complex and challenging task for nurses and knowing weaning criteria is most
essential component for getting successful outcome for the patients with mechanical ventilation.
Hence, this study was conducted to find out nurses’ knowledge regarding weaning criteria of the
patients with mechanical ventilation.
Methods: A descriptive cross sectional study design was used with 57 nurses working in critical
care unit of a teaching hospital, Bharatpur, Chitwan. The non-probability, enumerative sampling
technique was used. Data was collected by using self-administered semi structured questionnaire
during July, 2016. Association was analyzed using chi square.
Results: The level of knowledge regarding weaning criteria was 45.6% had adequate knowledge
while 54.4% had inadequate knowledge. The significant influencing variables for weaning
criteria were professional experience (p ≤ 0.001), professional experience in critical care area (p
≤ 0.001), clinical areas (p=0.002) and age (p=0.006) among nurses.
Conclusion: More than half of the respondents had inadequate knowledge regarding weaning
criteria and professional experience as a whole and critical care area, clinical area and age are
influencing variables for weaning criteria among nurses working in a teaching hospital Chitwan.
Hence, it is strongly recommended for need of protocol, in-service education, effective supervision
and reinforcement for improvement of knowledge on weaning criteria among nurses.

Keywords: Nurse, Knowledge, Weaning criteria, Mechanical ventilation.

Accepted on November 15, 2017

Introduction increased expenditure so the nurse must be well trained,

should develop sound knowledge and practical skills in
Ventilator weaning refers to the restoration of independent taking care of client with mechanical ventilator in order to
breathing in an individual dependent on mechanically assisted develop them as effective potential and competent nurse
ventilation, which involves gradually exposing the individual practitioner [5].
to longer periods of partially supported or independent
breathing [1]. About 90% of all ICU patients requiring mechanical ventilator
support as a lifesaving measure. Approximately 30% of
Ninety percentage of the ICU patient need mechanical ventilation patients who require mechanical ventilation are not easily
support globally. Intubation and mechanical ventilation are weaned [6].
often lifesaving procedures for them [2].
Nurses must be knowledgeable about the function and
About 6,469,674 patients need hospitalization in the six limitations of ventilator modes, causes of respiratory distress and
states of USA reported that 180,326 (2.8%) received invasive dysynchrony with the ventilator, and appropriate management
mechanical ventilation. Projecting to national estimates, there in order to provide high-quality patient-centred care [7].
were 790,257 hospitalizations involving mechanical ventilation
approximately 20% of patients who received mechanical Objectives
ventilation did not receive intensive care. [3]. • To find-out nurses’ knowledge regarding weaning
Weaning patients from the ventilator is complex as the nurse criteria of the patients with mechanical ventilation.
needs to discontinue ventilation while providing continuous • To identify the nurses’ knowledge regarding weaning
care, patient-focused, individualized weaning care plans and criteria of the patients with mechanical ventilation
highlighting the expanding role of the ICU nurse [4].
• To find out the association between level of knowledge
Delays in weaning the patient from mechanical ventilation regarding weaning criteria of the patients with mechanical
increase the number of complications and may lead to ventilation and selected variables.

11 J Pulmonol Clin Res 2017 Volume 1 Issue 1

Citation: Pradhan C, Shrestha R. Nurses’ knowledge regarding weaning criteria of the patients with mechanical ventilation in a teaching hospital,
Chitwan. J Pulmonol Clin Res. 2017;1(1):11-14.

Materials and Methods Table: 1. Respondents’ socio-demographic characteristics n=57.

Variables Frequency Percentage
A hospital based cross sectional study was conducted among
Age group (in years)
fifty seven nurses’ working at the Chitwan Medical College
20-24 44 77.2
Teaching Hospital, Chitwan. Non probability, enumerative
25-29 13 22.8
sampling technique was used. Mean ± Standard Deviation=22.79 ± 2.177
It was carried out at critical care units like Medicine Intensive Marital status
Care Unit (MICU), Coronary Care Unit (CCU), and Surgery Married 13 22.8

Intensive Care Unit (SICU)/Neuro Surgery Intensive Care Unit Unmarried 44 77.2
Place of residence
(NSICU). The study population was all the nurses working
Rural 18 31.6
in critical care units of CMCTH who were Registered nurse,
Urban 39 68.4
passed out PCL and Bachelor degree and who have >6 month
Religion
experience in critical areas. Semi structured, self- administered
Hindu 56 98.2
questionnaire was used to measure the knowledge of respondents. Non hindu 1 1.8

Results Ethnicity
Brahmin/Chhetri 41 71.9
Socio-demographic characteristics of respondents Janajati/Dalit 16 28.1
Professional qualification
In regards to socio-demographic characteristics, out of 57
PCL nursing 35 61.4
respondents, mean age was 22.79 ± 2.17 and majority of the
Bachelor nursing 22 38.6
respondents were belongs to 20-24 years (77.2%), unmarried
Total professional experience (in years)
(77.2%), residing in urban (68.4%), Hindu (98.2%), Brahmin/ ≤2 years 45 78.9
Cherty (71.9%) professional qualification especially PCL >2years 12 21.1
nursing (61.4%),total professional experience ≤ 2years (78.9%), Clinical area
working in Medical intensive care unit and Surgical intensive Medicine Intensive care Unit 22 38.6
care unit/Neurosurgery intensive care unit (38.6%) ,professional Surgery Intensive care Unit/
22 38.6
experience in critical care area ≤ 2years (89.5%), annual income Neurosurgery Intensive care Unit

less than or equal to 1, 50,000 (NPR) was (50.9%), did not get Coronary care Unit 13 22.8
Professional experience in critical care area
chance to have training on Mechanical Ventilation (75.4%),
≤2years 51 89.5
and guidelines on weaning criteria of mechanical ventilator
>2 years 6 10.5
available in their ward (50.9%) (Table 1).
Annual Income (in NPR)
Level of Knowledge regarding Weaning Criteria among Nurses ≤1,50,000 29 50.9
had inadequate knowledge (54.4%) and adequate knowledge >1,50,000 28 49.1
(45.6%) regarding weaning criteria (Table 2). Training on mechanical ventilation
Yes 14 24.6
Association between Level of Knowledge regarding Weaning No 43 75.4
Criteria and Selected Variables. Similarly, showed that Available guidelines on weaning criteria
association between level of knowledge regarding weaning Yes 29 50.9
criteria and selected variables. There is association between No 28 49.1
level of knowledge regarding weaning criteria with age (p
≤ 0.006), professional experience (p ≤ 0.001), clinical areas Table 2: Respondents’ level of knowledge regarding weaning criteria
(p=0.002) and professional experience in critical area (p ≤ of mechanical ventilation (n=57).
0.001) (Table 3). Level of knowledge Number Percentage
Inadequate (<19.61) 31 54.4
Discussion Adequate (≤19.61) 26 45.6
Total 57 100
The present study aimed to find-out knowledge regarding
weaning criteria among nurses working in a teaching hospital, Mean ± SD (19.61 ± 4.86).
Chitwan. The major findings were reported:
Regarding knowledge on ventilator weaning (54.4%)
(i) More than half of the nurses had inadequate knowledge inadequate and (45.6%) adequate knowledge. The findings
regarding weaning criteria. of this study was supported by a study conducted in Nelson
Mandela Metropolitan University, Port Elizabeth, South Africa
(ii) Age, total professional experience, critical care unit experience
[9] reported that 92.5% of respondents obtained a knowledge
and clinical area were significant influencing variables for
score ≤ 50% whereas 7.5% of respondents obtained scores of
knowledge regarding weaning criteria among nurses.
≥50% and analytical, cross sectional survey was also done at
This might be due to majority of nurses were of age group 20-24 South Africa, Johannesburg which stated that knowledge of
years. This findings is contradictory with a another study finding ICU trained nurses was found lacking.
conducted in Yenepoya Medical College Hospital, Deralakatte,
Regarding knowledge on definition of mechanical ventilation
Mangalore [8] revealed that age was not a influencing variable
(87.7%),definition on ventilator weaning (71.9%).The findings
for level of knowledge on weaning criteria among nurse.

J Pulmonol Clin Res 2017 Volume 1 Issue 1 12

 Pradhan/Shrestha

Table 3: Association between respondents’ level of knowledge regarding weaning criteria and selected variables.
Level of Knowledge
Variables χ2 p value
Inadequate No. (%) Adequate No. (%)
Age (In Years)
20-24 29 (50.87) 15 (26.31)
7.477 0.006#
25-29 3 (5.26) 10 (17.54)
Marital Status
Married 5 (8.77) 8 (14.03)
2.138 0.144*
Unmarried 27 (47.3) 17 (29.82)
Place of Residence
Rural 13 (22.80) 5 (8.77)
2.763 0.096*
Urban 19 (33.33) 20 (35.08)
Religion
Hindu 31 (54.38) 25 (43.85)
0.795 0.373#
Non Hindu 1 (1.7) -
Ethnicity
Brahmin/Chhetri 21 (36.84) 20 (35.08)
1.436 0.231*
Janajati/Dalit 11 (19.29) 5 (8.77)
Professional Qualification
PCL Nursing 23 (71.9) 12 (48)
3.376 0.066*
Bachelor in nursing 9 (28.1) 13 (52)
Professional Experience (In years)
≤2 23 (40.35) 6 (10.52)
12.871 <0.001*
>2 9 (15.78) 19 (33.33)
Clinical Area
ICU 20 (35.08) 24 (96)
12.269 0.002#
CCU 12 (21.05) 1 (1.75)
Professional experience in critical area (in years)
≤2 27 (47.36) 10 (17.54)
12.314 <0.001*
>2 5 (8.77) 15 (26.31)
Annual income (in NPR)
<1,50,000 15 (26.31) 14 (24.56)
0.468 0.494*
>1,50,000 17 (29.82) 11 (19.29)
Training on mechanical ventilation
Yes 7 (12.28) 7 (12.28)
0.284 0.594*
No 25 (43.85) 18 (31.57)
Available guideline on weaning criteria
Yes 15 (26.31) 14 (24.56)
0.468 0.494*
No 17 (29.82) 11 (19.29)

Significant level at 0.05 #Fisher's exact *Pearson chi square.

was supported by a hospital based descriptive study done in References

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13 J Pulmonol Clin Res 2017 Volume 1 Issue 1

Citation: Pradhan C, Shrestha R. Nurses’ knowledge regarding weaning criteria of the patients with mechanical ventilation in a teaching hospital,
Chitwan. J Pulmonol Clin Res. 2017;1(1):11-14.

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*Correspondence to:
Shrestha R
Associate Professor
Chitwan Medical College
Bharatpur
Nepal
E-mail: rosyshrestha2005@yahoo.com

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