Implementation of a nurse-driven sedation protocol in the ICU

Abstract

Background: Managing anxiety, pain and delirium in critically ill patients is an ongoing challenge. Differences in physician practice, variations of pharmacological agents, as well as concentrations and units can increase the risk of medication error Personal preferences, subjectivity, and nurses' level of expertise are variables when titrating analgesic and sedation infusions.

Purpose: The purpdse of this study was to evaluate the perceived benefits of implementing a standardized nurse-driven sedation protocol in the ICU. We examined its impact on the rates of medication errors and perceptions of staff using the protocol.

Design: This descriptive study used a survey to collect data.

Sample: We used a convenience sample of 75 nurses who worked in the ICU during the implementation of the sedation protocol.

Results: Analysis of variance was completed comparing all sub-scale scores. No statistical significance was found, but scores did not decrease over time. No medication errors or near misses were reported throughout the sedation protocol implementation. Qualitative comments from staff provided feedback and assisted in identifying issues with the protocol.

Conclusion: We believe that the implementation of the sedation protocol has been beneficial in our adult ICU. Findings indicate that with experience and resources nurses can manage anxiety, pain and delirium more confidently than without such a protocol. Critical care nurses, given the right tools, education, and support can make decisions that promote positive outcomes for patients receiving sedation and analgesia in the ICU.