2.50
Hdl Handle:
http://hdl.handle.net/10755/157112
Category:
Abstract
Type:
Presentation
Title:
Strategies for Improving Daily Interrruption of Sedation by Nurses in the MICU
Author(s):
Hardy, Mary
Author Details:
Mary Hardy, University of Virginia Health System, Charlottesville, Virginia, USA, email: maire24@yahoo.com
Abstract:
PURPOSE: Daily interruption of sedation (DIS) is an independent nursing intervention that decreases both the number of days patients receive mechanical ventilation and ICU length of stay. Due to knowledge deficits and lack of a standardized approach for triggering and recording performance of the DIS, DIS was performed approximately half of the time on eligible patients at our institution. We undertook a nursing-led multidisciplinary initiative to improve knowledge of and adherence with DIS in the MICU. Description: After reviewing evidence-based practice and successful strategies at other institutions, a multidisciplinary committee developed several strategies for improving adherence with DIS performance. First, a pathway was developed in the physician ordering system so that a DIS was automatically ordered on any patient for whom a sedative drip was ordered. This triggered in the computerized medication administration a scheduled DIS at 0900. By having to chart whether a DIS was performed, this provided a daily reminder for the nurse of the importance of DIS. Reasons why a DIS was not done could be selected, providing further education. This also provided an easy means of auditing adherence with DIS. During implementation of the pathway, numerous opportunities for education, including didactic sessions, poster presentations, and clinical pearls about DIS were provided. We partnered with respiratory therapy to pick a standardized time for DIS performance so it could be paired with ventilator weaning trials. Finally, charge nurses did more extensive audits during the first two months of implementation to provide detailed information about barriers to and adherence with performance of DIS. EVALUATION: Data from the audit tool were analyzed and compared to rates of DIS prior to implementation of the pathway and education. In the first two months after the new ordering and charting pathway was instituted for sedation drips and DIS, 82% of patients who met the criteria for receiving DIS had one performed, compared to 50% before implementation. Performance of DIS also resulted in a decrease in the use of continuous sedative drips, with only 25% of mechanically ventilated patients on a sedative drip.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleStrategies for Improving Daily Interrruption of Sedation by Nurses in the MICUen_GB
dc.contributor.authorHardy, Maryen_GB
dc.author.detailsMary Hardy, University of Virginia Health System, Charlottesville, Virginia, USA, email: maire24@yahoo.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157112-
dc.description.abstractPURPOSE: Daily interruption of sedation (DIS) is an independent nursing intervention that decreases both the number of days patients receive mechanical ventilation and ICU length of stay. Due to knowledge deficits and lack of a standardized approach for triggering and recording performance of the DIS, DIS was performed approximately half of the time on eligible patients at our institution. We undertook a nursing-led multidisciplinary initiative to improve knowledge of and adherence with DIS in the MICU. Description: After reviewing evidence-based practice and successful strategies at other institutions, a multidisciplinary committee developed several strategies for improving adherence with DIS performance. First, a pathway was developed in the physician ordering system so that a DIS was automatically ordered on any patient for whom a sedative drip was ordered. This triggered in the computerized medication administration a scheduled DIS at 0900. By having to chart whether a DIS was performed, this provided a daily reminder for the nurse of the importance of DIS. Reasons why a DIS was not done could be selected, providing further education. This also provided an easy means of auditing adherence with DIS. During implementation of the pathway, numerous opportunities for education, including didactic sessions, poster presentations, and clinical pearls about DIS were provided. We partnered with respiratory therapy to pick a standardized time for DIS performance so it could be paired with ventilator weaning trials. Finally, charge nurses did more extensive audits during the first two months of implementation to provide detailed information about barriers to and adherence with performance of DIS. EVALUATION: Data from the audit tool were analyzed and compared to rates of DIS prior to implementation of the pathway and education. In the first two months after the new ordering and charting pathway was instituted for sedation drips and DIS, 82% of patients who met the criteria for receiving DIS had one performed, compared to 50% before implementation. Performance of DIS also resulted in a decrease in the use of continuous sedative drips, with only 25% of mechanically ventilated patients on a sedative drip.en_GB
dc.date.available2011-10-26T19:25:54Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:25:54Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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