Background: Current evidence-based practice guidelines show that lighter sedation reduces mechanical ventilator days (MVD) and intensive care (ICU) length of stay (LOS). Guidelines (2018) for the management of pain, agitation, delirium, immobility, and sleep were released to direct appropriate high-quality care to achieve positive outcomes. However, studies demonstrated there were barriers to compliance of these guidelines.
Objective: To improve compliance with an existing evidence-based sedation protocol in an intensive care, and, thereby, improve patient outcomes (MVD and ICU LOS).
Methods: The three-month quality improvement (QI) project evaluated processes leading to compliance with the guideline. First, nurses were surveyed to determine knowledge and comfort with the guideline. Based on the guideline and data from nurses, education was provided on sedation medications, mechanical ventilation, the EBP sedation protocol, and focused on spontaneous awakening and breathing trials. Protocol comfort and compliance was evaluated. Results: Primary compliance issues were lack of experience and education. Despite education, MVD increased by 23% and ICU LOS by 7%.
Implications for Practice: Staff education concerning sedation guidelines is key to achieving compliance and optimal MVD and ICU LOS
