Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks.

Background: Device-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort.

Objective: To examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask compared with a full-face mask.

Methods: A before-after study of a convenience sample of patients with noninvasive ventilation orders in 5 intensive care units was conducted.

Tracheostomy protocol: experience with development and potential utility.

Objectives: To examine the feasibility and potential utility of a tracheostomy protocol based on a standardized approach to ventilator weaning.

Design: Prospective, observational data collection.

Setting: Academic medical center.

Improved extubation rates and earlier liberation from mechanical ventilation with implementation of a daily spontaneous-breathing trial protocol.

Background: Daily spontaneous-breathing trials (SBTs) are promulgated as the best method for assessing readiness for discontinuation of mechanical ventilation. SBT protocols have also been shown to improve outcomes as opposed to wild-type implementation of daily SBT recommendations. Here we determine whether implementation of a mandatory, protocol-driven daily SBT on all ventilated patients in the ICU improves extubation rates and accelerates liberation from mechanical ventilation.

The effect of respiratory therapist-initiated treatment protocols on patient outcomes and resource utilization.

Context: Physicians frequently prescribe respiratory treatments to hospitalized patients, but the influence of such treatments on clinical outcomes is difficult to assess.

Objective: To compare the clinical outcomes of patients receiving respiratory treatments managed by respiratory care practitioner (RCP)-directed treatment protocols or physician-directed orders.

Design: A single center, quasi-randomized, clinical study.