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Initiation of Early Extubation Wean Protocol in Post-Cardiac Surgery Patients

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Initiation of Early Extubation Wean Protocol in Post-Cardiac Surgery Patients

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I certify that:
1. This assignment is entirely my own work, with any words and/or ideas from other sources (print, Web, other media, other individual groups) being properly cited in text, and placed in a proper reference section.
2. Any material used from another assignment has been discussed with and approved by the instructor.
Student’s Signature:  Cherise Williams
Course Submitted: DNP
Term: Summer 2018
Date: 9/4/2018

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The dynamic process of evaluating and modifying the data tables has begun in reverse order from which they were constructed. Each data table will be thoroughly assessed utilizing the concepts learned in the NURS 718 course. The knowledge gained will allow comprehensive evaluation of data for the use in this DNP project.

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Multiple changes have been made to the data tables, with most occurring in the first two tables. The evolution of the tables is visually and structurally evident. The most difficult process was learning the ins and outs of APA formatting of large tables. Many hours were spent formatting alone, but overall a wealth of knowledge was gained not only from creating each table, but from pulling it all together in the end.

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The purpose of this DNP project is to: (a) evaluate current guidelines and standards of care for extubation protocols in the post-cardiac surgery population; (b) implementation of extubation protocol as a quality improvement program at Wilkes-Barre General Hospital; and (c) evaluation for practice change related to a practice gap. The project goal is to decrease ventilator hours with mean ventilator hours less than six hours post-operatively and meet the quality measure as set by the STS.

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Measurement Table, AKA, "Lessons Learned"

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Measurement Table, AKA, "Lessons Learned"

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Completed a full shift of the columns and rows. Also, shortened the information provided under the author column. Removed the fancy design.

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Data Analysis Table, AKA, "It's All Making Sense"

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Data Analysis Table, AKA, "It's All Making Sense"

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Cherise Williams. Data Analysis Table Assignment

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Sampling Table, AKA, "The Second Attempt"

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Sampling Table, AKA, "The Second Attempt"

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In adult post-operative cardiac surgery patients (P), what is the impact of an early extubation ventilator wean protocol (I) compared to the current practice of physician directed ventilator wean (C) on ventilator hours (O) over a six-week period?

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Cherise Williams, MSN, AGACNP-BC, APRN, RNFA, CCRN

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Cherise Williams, MSN, AGACNP-BC, APRN, RNFA, CCRN

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This E-poster outlines the evolution of data collection and interpretation process in the development of this DNP project

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The quality measure set by The Society of Thoracic Surgeons (STS) for ventilator hours in coronary artery bypass graft surgery is less than 24 hours (Quality & Safety, 2011). Despite this measure, less than six hours is a standard of care for post-cardiac surgery patients (Akhtar et al., 2016). Incorporating wean protocols with observed subsequent decreased ventilator hours is demonstrated in the research by Akhtar et al., (2016); Camp et al., (2009); Cove et al., (2016); Fitch et al., (2014); and Gutsche et al., (2014).

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Research Design Table, AKA, "The First Table"

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Research Design Table, AKA, "The First Table"