• Lisa Cannella and Imke Casey.
• Lisa Cannella is a practicing cardiac nurse anesthetist at Largo Medical Center, Largo, Florida.
• Crit Care Nurse. 2025 Feb 1; 45 (1): 212821-28.

BackgroundProlonged intubation has been associated with unfavorable outcomes after cardiac surgery. A standardized approach is needed to ensure prompt extubation and shorten intensive care unit stays.Local ProblemThis quality improvement project was designed to evaluate the impact of a fast-track extubation protocol on time to extubation and intensive care unit length of stay.MethodsThe intervention group consisted of 26 adult cardiac surgery patients who underwent the fast-track extubation protocol. A Mann-Whitney test was used to compare time to extubation and intensive care unit length of stay in this group with those of a pair-matched control group of patients from the previous year who did not undergo the fast-track extubation protocol.InterventionsAn evidence-based literature review was used to develop a fast-track extubation protocol involving extubation in less than 6 hours. An educational activity was created to improve intensive care unit staff members' knowledge of the fast-track extubation protocol, and its effectiveness was measured by a posttest score of 80%.ResultsThe percentage of patients with extubation times of less than 6 hours was significantly higher in the fast-track extubation protocol group than in the pair-matched control group (U = 179, P = .003). The mean intensive care unit stay decreased from 2.92 days in the control group to 1.85 days in the fast-track extubation protocol group.ConclusionImplementing a fast-track extubation protocol for adult cardiac surgery patients shortened time to extubation and intensive care unit stay, expediting and improving recovery processes in the intensive care unit.©2025 American Association of Critical-Care Nurses.

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