CSI Summary
Available only to registered AACN.org users.
Project Topic:
Improve the six-hour fast track extubation percentage and length of stay in the ICU
Hospital, City and State:
Loyola University Medical Center, Maywood, Illinois
Unit:
2 Cardiovascular Intensive Care Unit
CSI Participants:
- Joseph Covey, RN, BSN
- Victoria Patino, RN, BSN
- Oksana Sydorenko, RN, BSN
- Cory Thomas, RN, BSN
Project Goals/Objectives:
- Increase bedside nurses’ confidence in extubation by 10%
- Increase the number of patients who are extubated within 6 hours after surgery to 75%
- Decrease our patients’ length of stay by 23 hours
Project Outcomes:
- Increased bedside nurses' confidence in extubating postoperative patients by 10%
- Increased the number of patients extubated within 6 hours after surgery to 81.86%
- Decreased patient’s length of stay by 30.12 hours within 6 months
Project Overview:
Fast-track extubation time was at a lower percentage than the benchmark per the Society of Thoracic Surgeons (STS). From January 2024 to June 2024 our average successful fast track time was 51.56%. After reviewing evidence-based research, we decided that in an effort to increase our fast-track percentage, a nurse-driven protocol was necessary. After meeting with our CVICU Medical and Surgical directors, we were able to finalize our new protocol. Prior to implementing our protocol, we hosted educational sessions for bedside nurses. We designed this protocol to not only to improve fast track times and decrease length of stay, but also to increase nurse autonomy and confidence.
The protocol was implemented in November 2024 after hosting our project kickoff party. During the next six months, the CSI members audited the cases and shared results monthly with the nurses as well as the ICU and surgical teams. After the implementation of our new protocol, our results have shown positive results. Between November 2024 to April 2025, our successful fast track extubation percentage increased to 81.86% while our length of stay decreased from 97 to 67 hours.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.