الفهرس 
Chapter I: IntroductionOnly 14 pages are availabe for public view
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Abstract
Modified Ventilator bundle is defined as the execution of a group of best evidence-based intervention all as integer package for a defined patient population, which when each one of them is executed individually will prompt improved patient’s recovery process and results, yet when performed all together, they providing better results than implemented individually. Application of ventilator bundle that may have a significant decrease in VAP rates, antibiotic administration and death and morbidity rate, hospital expenses, improvement of weaning strategies and time-span-time of MV connection, hospitalization, ICU stay. This study aimed to apply a modified ventilator bundle and evaluate its effect on weaning among mechanically ventilated patients. To fulfill the aim of this study the following research hypothesis was formulated: The study group of patients for whom all elements of the modified ventilator bundle were applied completely would get higher weaning scores and shorter duration of the connection to mechanical ventilator compared with the control group of patients who received the routine hospital nursing care.
Quasi-experimental research design was utilized in the current study. A Purposive sample of 100 mechanically ventilated patients was assigned in the current study started from initiation of MV connection till extubate; the patients were matched for their age and medical characteristics and were divided randomly into two equal groups. In the first study group (n= 50) the patients received the modified ventilator bundle practices completely. In the second control group (n= 50) the patients received routine hospital nursing care. Data collection tools: two tools were used. First tool: patient assessment sheet includes two parts, part one: patient demographic and medical characteristic part two: Physical assessment record. Second tool: Weaning process assessment checklists.
As regard to the finding of the current study revealed that, shows that, (60.0%) of the study group compared with (68.0%) of the control group their age ranged between (40– 59) years with mean age / SD (48.1 ± 11.3) and (51.1 ± 9.8) years respectively. As regards gender, (64.0%) of the study group compared with (70.0%) of the control group were males. According to marital status, (78.0%) of the study group compared with (90.0%) of the control group were married. Regarding residence, (62.0%) of the study group compared with (72.0%) of the control group lived in rural area, Related to their educational level, (48.0%) of the study group compared with (42.0%) of control group cannot read and write therefore the most of them were occupied as worker /farmer (38%, 46%). The result of the current study revealed, there were statistically significant differences between studied groups according to their duration of mechanical ventilation/days with (P-value .005). In addition There were statistically significant differences between both study and control groups regarding their total weaning scale in the 1st, 2nd, 3rd and 4th observation (P-value ≤ .001, 002, 05 and .025) respectively. Recommendations: Designing an in-service training educational program for the critical care nurses to upgrade nurses’ knowledge and practice regarding the modified ventilator bundle practices. Replication of the current study on a larger probability sample from different geographical locations to generalize the results.