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Thesis/Dissertation Information
- Degree Disciplines:
- Nursing
Notes
- Abstract:
- Background: The purpose of sedation for patients receiving ventilator support is to achieve comfort and optimize patient-ventilator synchrony. Overuse of sedation has been shown to have adverse effects. National and international guidelines recommend a sedation-as-needed approach; however, evidence suggests poor guideline adherence. Purpose: The purpose of this study was to decrease practice variation in sedation management during the weaning process from mechanical ventilation through an educational intervention based on current guidelines for sedation practices in the intensive care unit. Two project questions were formulated: (a) What are some of the reasons given by critical care nurses as to why once daily sedation interruption is not utilized for all mechanically ventilated patients in the ICU? (b) How would an educational intervention affect nurses’ knowledge of sedation guidelines during the weaning process? Theoretical framework: The Donabedian model, which identifies three key components: structure, process, and outcome. Methods: A pretest/ posttest design with an educational intervention was used. The pretest entailed a self-administered survey evaluating the most salient factors of nurses’ sedation and weaning practice in the ICU. The educational intervention encompassed an active component for systematic assessment of mechanically ventilated patients, with passive reinforcements. The posttest assessed participants’ knowledge acquisition through responses to patient vignettes. Results: For the first question, critical care nurses cited (a) the possibility of respiratory compromise (34%), (b) patient-initiated device removal (29%), and (c) compromising patient comfort (11%). A total of 41% used a sedation protocol despite institutional guidelines within their ICU, and less than 53% performed daily sedation interruption 100% of the time. After the educational intervention, 100%-75% of participants properly identified indications and contraindications for daily sedation interruption. A total of 79% properly identified the need to assess and treat pain before sedation, and 86% properly identified the need to seek underlying causes of agitation. Fewer than 65% felt nurses’ contributions influence decisions on mechanical ventilation. Conclusions: An active educational intervention with the use of vignettes proved useful in improving critical care nurses’ guideline knowledge application. More emphasis should be placed on continuous professional development in mechanical ventilation and sedation, as well as nurses’ involvement in guideline development.
- Thesis:
- Thesis (DNP)--Barry University, 2015.
- Bibliography:
- Includes bibliographical references (leaves 44-53).
Record Information
- Source Institution:
- Barry University
- Holding Location:
- Barry University Archives and Special Collections
- Rights Management:
- Copyright Maritza Scarlet Baez. Permission granted to Barry University to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
- Resource Identifier:
- RT120.I5 B34 2015_BaezMaritza ( BU-Local )
- Classification:
- RT120.I5 B34 2015 ( lcc )
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