Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Komal Pandya

Committee Member

Dr. Candice Falls

Abstract

Purpose: Sedation protocols have been positively correlated with improved patient outcomes in the intensive care unit (ICU). Therefore, healthcare leaders should direct efforts to improving protocol compliance through evidence-based strategies. The purpose of this study was to evaluate the impact of a multifaceted intervention, consisting of educational outreach, point of care (POC) reminders, and audit and feedback (A&F), on nurse compliance with an ICU sedation protocol. A secondary data analysis was performed to evaluate the impact of the intervention on patient outcomes.

Methods: This was a before/after comparative analysis. A Research Electronic Data Capture (REDCap) pre-survey (n=58) was distributed to cardiovascular intensive care unit (CVICU) nurses (n=139) via a modified email listserv. An educational PowerPoint session via Zoom was delivered to staff during two non-mandatory unit council meetings. A modified post-survey evaluated (n=43) was distributed to nurses who completed the pre-test and attended at least one of the educational sessions. The post-survey evaluated the impact of the educational session on nursing knowledge, attitudes, and perceived barriers to protocol utilization. A series of multiple-choice questions were incorporated in the survey to evaluate nursing knowledge of evidence-based guidelines and protocol components. Attitudes were scored using an attitude-specific component of the Nurse Sedation Practices Scale (NSPS). Barriers were identified through true or false, multiple response, or open response questions. A secondary multifaceted intervention was implemented over three months to improve sedation protocol compliance and patient-related health outcomes. Sedation practices, mechanical ventilator (MV) duration, delirium, and reintubations were compared before (n=92) and after (n=82) the intervention by performing a retrospective chart review.

Results: There was a significant improvement in knowledge scores and NSPS scores post- educational intervention (p

Conclusion: This study demonstrated the positive impact of a multifaceted educational approach on nursing knowledge and attitudes regarding an evidence-based sedation protocol. Furthermore, this study suggests that a multifaceted intervention may improve quality of care by reducing MV duration. Future research should focus on applying this strategy to vulnerable populations who are susceptible to prolonged MV. Furthermore, future research should evaluate strategies to improve the feasibility of this approach.

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