μImpact of a nursing-driven sedation protocol with criteria for infusion initiation in the surgical intensive care unit
| Autor: | Justin B. Kaplan, Daniel S. Eiferman, Kyle Porter, Jennifer MacDermott, Jessica Brumbaugh, Claire V. Murphy |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Critical Care medicine.drug_class Sedation medicine.medical_treatment Conscious Sedation Nursing Critical Care and Intensive Care Medicine 03 medical and health sciences Benzodiazepines 0302 clinical medicine Clinical Protocols Medicine Humans Hypnotics and Sedatives Pain Management Anesthesia Infusions Intravenous Aged Pain Measurement Retrospective Studies Mechanical ventilation Benzodiazepine business.industry Incidence (epidemiology) Delirium 030208 emergency & critical care medicine Retrospective cohort study Length of Stay Middle Aged Respiration Artificial Analgesics Opioid Intensive Care Units Treatment Outcome 030228 respiratory system Opioid Sedative Female medicine.symptom Analgesia business medicine.drug |
| Zdroj: | Journal of critical care. 50 |
| ISSN: | 1557-8615 |
| Popis: | Analgesia and sedation protocols (ASPs) reduce duration of mechanical ventilation (MV) in the medical intensive care unit (ICU), but data in the surgical ICU (SICU) are limited. The objective of this study was to determine the impact of a nursing-driven ASP with criteria for infusion initiation in the SICU.A single-center, retrospective study compared ventilator-free days at day 28 from start of MV (VFD28) before and after ASP implementation. Secondary endpoints included cumulative opioid and sedative requirements, level of sedation, incidence of delirium, SICU and hospital length of stay.One hundred thirty two patients were included (66 per group). The protocol group had greater VFD28 compared to the control group (21 vs. 14.5 days, p = .04). Lower rates of benzodiazepine (42.4% vs. 84.8%, p .001) and opioid (24.2 vs. 78.8, p .001) infusion use occurred in the protocol group, resulting in lower cumulative doses per ventilator-day through day 7. The protocol group had more documented sedation scores within target range. There were no differences in ICU delirium, SICU or hospital length of stay.A nursing-driven ASP with criteria for infusion initiation in mechanically-ventilated SICU patients may increase ventilator-free time, maintain patients at the target sedation goal, and reduce opioid and benzodiazepine utilization. |
| Databáze: | OpenAIRE |
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