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Related Concept Videos

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Assessment of Respiration01:23

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The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
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Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

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Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
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Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns
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Real-World Data: Exploring Spontaneous Breathing Trials and Extubation.

Cheryl A Smith-Miller1, Tamara Blakeney2, Nancy Havill2

  • 1Center for Nursing Excellence, UNC Medical Center, University of North Carolina at Chapel Hill Office of Human Research Ethics, Chapel Hill, North Carolina, USA.

Nursing in Critical Care
|February 16, 2026
PubMed
Summary
This summary is machine-generated.

The time from spontaneous breathing trials (SBTs) to extubation increased significantly between 2020 and 2023, influenced by unit practices, staffing, and culture, not just patient readiness.

Keywords:
critical care nursingevidence‐based practiceintubationmoral distress

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Area of Science:

  • Critical care medicine
  • Respiratory therapy
  • Health services research

Background:

  • Real-world data (RWD) are crucial for evaluating treatment effectiveness in clinical practice.
  • Limited research exists on the temporal relationship between spontaneous breathing trials (SBTs) and extubation success.
  • Understanding provider use of SBT data in extubation decisions is needed.

Purpose of the Study:

  • To compare unit-specific SBT and extubation rates and time intervals across two distinct periods.
  • To investigate healthcare providers' extubation practices and their utilization of SBT data.
  • To identify factors influencing the timing and success of extubation.

Main Methods:

  • A sequential mixed-methods approach combining retrospective chart reviews and interviews.
  • Analysis of SBT and extubation times across five intensive care units (ICUs) at a Level I trauma center.
  • Qualitative analysis using grounded theory and content analysis to explore clinical practices and decision-making.

Main Results:

  • Significant variation in extubation outcomes and timing across ICUs and over time (2020-2023).
  • The time from SBT to extubation significantly increased over the study period (p < 0.01).
  • Successful extubation was more likely in 2023 compared to 2020, particularly in Unit C (OR=1.56).

Conclusions:

  • Extubation timing is influenced by patient readiness, staffing, workflow, and professional culture.
  • Variability in practices across units and time suggests the impact of external factors like the pandemic.
  • An adaptable, data-driven approach is needed to optimize critical care practices and patient outcomes.