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- A systematic review of nurse‐led weaning protocol for mechanically ventilated adult patientsPublication . Hirzallah, Fatima Mohammad; Alkaissi, Aidah; Barbieri-Figueiredo, MCObjectives: The aim of this systematic review is to synthesize the current best evidence for the effectiveness of weaning protocols led by nurses compared with usual physician-led care. Background: Protocol-directed weaning has been shown to reduce the duration of mechanical ventilation. Studies have reported that a weaning protocol administered by nurses leads to a reduction in the duration of mechanical ventilation and has a major effect on weaning outcomes. This can have especially positive consequences for critically ill patients. Study design: Systematic review with meta-analysis. Search strategy: The databases CINAHL, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched from as far back as the database allowed until January 2016. Inclusion and exclusion criteria: Searches were performed to identify the best available evidence including quantitative studies of nurse-led weaning protocols formechanically ventilated adult patients. We excluded all studies of weaning protocols implemented by non-nurses and non-invasive mechanical ventilation and studies that addressed patient populations younger than 18 years of age. Results: The database searches resulted in retrieving 369 articles. Three eligible studies with a total of 532 patients were included in the final review. Pooled data showed a statistically significant difference in favour of the nurse-led weaning protocol for reducing the duration of mechanical ventilation (mean differences=−1.69 days, 95% confidence interval =−3.23 to 0.16), intensive care unit length of stay (mean differences=−2.04 days, 95% confidence interval=−2.57 to −1.52, I2 =18%, and p=0.00001); and hospital length of stay (mean differences=−2.9 days, 95% confidence interval=−4.24 to −1.56, I2 =0%, and p=0.00001). Conclusion: There is evidence that the use of nurse-led weaning protocols for mechanically ventilated adult patients has a positive impact on weaning outcomes and patient safety. Relevance to clinical practice: This review provides evidence supporting intensive care unit nurses’ crucial role and abilities to lead weaning from mechanical ventilation.