The Science Journal of the American Association for Respiratory Care
INTRODUCTION: Managed-care continuously challenges all departments to revise and reassess the methods and equipment utilized to deliver optimum patient care. Fast Trac Weaning helped us meet the challenge. Fast Trac Weaning is defined, by the Journal of Anesthesiology, as extubation within 1 to 6 hours after cardiac surgery.
Fast Trac Weaning and a dedicated program to monitor supply - equipment cost and man-hours has proven to have positive outcomes. The greatest benefit was experienced by our patients. Specifically, they experienced less anxiety due to the shorter length of intubation. Adopting Fast Trac Weaning has also decreased length of stay, patient and hospital cost, and increased staff productivity.
Methods: We identified the need for the same ventilator tubing to follow the patient through their continuum of care. A protocol was developed that outlined single use circuitry. This standard of practice eliminated multiple tubing changes at point of transport and extubation. By utilizing the surgical patient's current ventilator circuit in multiple settings, we eliminated the set up of additional tubing on transfer and at post-extubation.
The criteria selected to evaluate the effectiveness of this method consisted of: the incidence of inadvertent extubations; the incidence of elective reintubation post-Fast Trac Weaning; equipment cost comparison; personnel productivity; and patient length of stay.
CONCLUSION: Comparing airway management standard of practice with innovative equipment options and/or modifications resulted in several benefits. This change in practice using single circuitry in a triple function role resulted in increased patient satisfaction, decreased patient length of stay, decreased cost in equipment and labor, and increased staff productivity. Specifically, $11,640.00 per 1,000 patients in disposable equipment alone.
The utilization of the Fast Trac Weaning protocol also resulted in decreased inadvertent extubations, decreased elective reintubations and decreased adverse reactions. Fast Trac Weaning has been proven to be a safe and preferred method that has impacted significant cost containment in our acute post-operative care setting.