Postanesthesia care unit extubation protocol based on the Marker Model

In an attempt to clearly define nursing practice in the PACU, nurses and anesthesiologists worked collaboratively to develop an extubation protocol. The protocol is for patients no longer requiring mechanical ventilation and who will be extubated in the PACU. The protocol is unique in that it is written in a format derived from the Marker Model. Using a hierarchical concept, the Marker Model provides a framework for dividing nursing standards into three categories: structure, process, and outcome. While the extubation protocol illustrates an example of a process standard, the article also focuses on briefly describing the major components of the Marker Model and how they interrelate.