Date of Award
Spring 5-1-2022
Document Type
Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Advisor
Kacy Ballard, DNP, CRNA
First Committee Member
Brian Garrett, DNP, CRNA
Second Committee Member
Greg Stockton, DNP, CRNA
Keywords
Sedation, Assessment, Education, Intensive Care, Nursing
Subject Categories
Medicine and Health Sciences
Abstract
Nursing management of sedation medications in critical care patients is a complex responsibility, and studies have shown that proper use of sedation protocols can lead to improved patient outcomes. A knowledge gap among critical care nurses in the performance of Richmond Agitation Sedation Scale (RASS) assessments was identified within a critical care unit during the 2019 annual skills day. Inaccurate RASS assessments may lead to inaccurate sedation management according to the current unit protocol and evidence from the literature, and therefore may impact patient outcomes. This project aims to improve a clinical practice within an intensive care unit. The objective is to increase the number of staff nurses who perform and score RASS assessments accurately, determine how accurate RASS assessments can impact certain patient outcomes, and to provide suggestions on how to standardize education of RASS assessments for nurses in the intensive care unit. A baseline audit was completed in the form of an in-person observation of nurses performing RASS assessments on the unit. The baseline audit revealed 36% of nurses accurately performed RASS assessments on patients. Baseline internal data was compiled that included ICU length of stay for ventilated patients, time on the ventilator, and mortality among ventilated patients. A multi-faceted education series was provided to all critical care nurses. The education series was completed in May 2021. One month following the completion of this education series, a second audit of nurses, which mirrored the first audit, was completed to determine if a change in clinical practice occurred. The post-intervention audit revealed that 60% of nurses accurately performed RASS assessments on patients. Lastly, a post-intervention assessment of ICU length of stay for ventilated patients, time on the ventilator, and mortality for ventilated patients was completed. The results showed that along with an improvement in accuracy of RASS assessments, there was also a change in patient outcomes.
Licensing Permission
Copyright, all rights reserved. Fair Use
Recommended Citation
Dyer, Kimberly and Garvey, Courtney, "Sedation Assessment and Management in the Intensive Care Unit" (2022). Doctor of Nursing Practice Scholarly Projects. 63.
https://digitalcommons.otterbein.edu/stu_doc/63