Outcomes of an Advanced Practice Nurse-Led Respiratory Muscle Weakness Prevention Program among People with Ventilators: A Quasi-Experimental Study

Abstract

People with ventilators are at risk of limb and respiratory muscle weakness, affecting functional status and health service costs. Evidence has shown that early mobility and inspiratory muscle training positively affect respiratory muscle strength. However, there is limited research on this topic in Thailand. Thus, this quasi-experimental study aimed to test the effectiveness of a 2-week Respiratory Muscle Weakness Prevention Program on clinical outcomes among people with ventilators led by an advanced practice nurse. Forty-nine participants were recruited from two medical intensive care units and one sub-medical intensive care unit of a university-affiliated hospital in Bangkok, Thailand, from February to September 2023. The first 25 participants were in the comparison group and completed data collection. After that, 24 participants were recruited to the experimental group and received the program. Clinical outcomes were measured by maximum inspiratory pressure, ventilation duration, weaning duration, weaning success, intensive care unit length of stay, hospital length of stay, and health service costs. Data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, Chi-square test, Fisher’s exact test, two-way repeated measures analysis of variance, and multivariate analysis of variance. Results revealed that the experimental group significantly increased mean maximum inspiratory pressure and weaning success compared to the comparison group. The mean ventilation duration, weaning duration, intensive care unit length of stay, hospital length of stay, and health service costs in the experimental group were significantly lower than those in the comparison group. This study highlighted the benefit of an advanced practice nurse in implementing the Respiratory Muscle Weakness Prevention Program, which is evidence-based for people with ventilators. Thus, policymakers should establish the position of advanced practice nurses for people with complex problems. However, further study in other settings with a larger sample is needed before the program can be widely used.