Related Experiment Video
Updated: Jan 21, 2026

Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Implementing a Weaning Protocol for Cardiac Surgery Patients Using Simulation: A Quality Improvement Project
Catherine C Tierney1, Marilyn H Oermann, Margory A Molloy
1Catherine C. Tierney, DNP, RN, ACNP-BC, is a nurse practitioner for cardiovascular and thoracic surgery, Virginia Hospital Center, Arlington. Marilyn H. Oermann, PhD, RN, ANEF, FAAN, is a Thelma M. Ingles Professor of Nursing at Duke University School of Nursing, Durham, North Carolina. Margory A. Molloy, DNP, RN, CNE, CHSE, is an assistant professor and director of the Center for Nursing Discovery, Duke University School of Nursing, Durham, North Carolina. Lori Brien, MS, RN, ACNP-BC, is a nurse practitioner for cardiovascular and thoracic surgery, Virginia Hospital Center, Arlington. Cherith Neisler, BSN, RN, CCRN-CSC, is a nurse educator of cardiovascular and thoracic surgery, Virginia Hospital Center, Arlington.
Background:
Mechanical ventilation is the standard of care after cardiac surgery, but it imposes physiologic and psychological stress on patients. The Society of Thoracic Surgery recommends 6 hours as the goal for extubation, but 60% of our patients were not meeting this metric.
Objectives:
The objectives of this project were to decrease cardiac surgery patients' ventilation hours and intensive care unit length of stay using a ventilator weaning protocol.
Methods:
An evidence-based ventilator weaning protocol was developed, and nurses were prepared for its implementation using a simulation education program.
Results:
Ventilator hours were reduced from 7.74 to 6.27 (t = 2.5, P = .012). The percentage of patients extubated in 6 hours increased from 40% to 63.5% (χ = 7.757, P = .005). There was no statistically significant decrease in cardiovascular intensive care unit length of stay (17.15 to 15.99, t = 0.619, P = .537). Nurses' scores on a knowledge test increased significantly from pre (6.11) to post (7.79) (t = -5.04, P < .001). Their perception of confidence increased in weaning from pre (median, 4; IQR, 4,4) to post (median, 4; interquartile range [IQR], 4,5), z = -2.71, P = .007, and also in using the protocol from pre (median, 4; IQR, 3,4) to post (median, 4; IQR, 4,5) (z = -3.17, P = .002).
Discussion:
Using a nurse-led ventilator weaning protocol resulted in decreased ventilator hours for patients and increased knowledge and confidence for nurses.
Related Concept Videos
Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
Fischer Projections
Newman Projections
The organic molecules rotate across the single bonds leading to numerous temporary three-dimensional structures of varying energy known as...
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
Coordinates and Map Projections
Quality of Water

