ICU nurses research sedation protocols

Nurses and nurse researchers in Swedish Covenant Hospital's critical care units, ICU and IMCU, are conducting a new evidence-based study on how to decrease ventilator associated pneumonia (VAP) rates. Planning began in June 2009 and data collection will begin this fall.

The idea for a study arose after nurses began gathering information from clinical practice guidelines, researching literature and consulting with other hospitals in the area to find best practice models that can be adapted and used at SCH. This prelimary research indicated that, statistically, the risk of VAP is exponentially increased when a patient is intubated and on the ventilator for longer than 48 hours. Further research indicated that an effective way to decrease the number of ventilator days, and hence, VAP, is to initiate a sedation protocol to standardize the methods used in sedating the mechanically ventilated patient. 

Therefore, to investigate if the use of a sedation protocol decreases the length of mechanically ventilated days in patients, the staff in ICU and IMCU will create a protocol, which will include a means of assessing mechanically ventilated patients on a daily basis for their neurologic status. To create this protocol, nurses are using the Iowa Model of Evidence-based Practice, which is a framework to guide nurses to integrate research evidence and clinical expertise to improve practice. 

This research project combines multiple disciplines, including nursing, medicine, pharmacy, pain management and respiratory therapy. Research is lead by the Nursing Research Committee, Mark Richardson, nurse educator in critical care units and Lori Brajczewski, unit manager. It will be submitted to the Internal Review Board (IRB) at SCH for approval later this year.