Wake Me Up! It’s Time to Breathe With the ABCs

A lack of standardized practice for SAT and SBT in our health network often resulted in nurses discontinuing sedation only when requested by a provider, despite a daily SAT order. A review of current unit practice revealed that, due to rounds occurring about 12-1:00 p.m., SATs were performed later in the day, leaving patients intubated until later in the afternoon. In addition, chart audits revealed escalation of sedation medications with improper RASS scoring. These factors directly impact total ventilator days, ICU and hospital length of stay, and risk of VAP/VAE. During project kickoff, our CSI team educated staff about RASS and the benefits of performing daily SATs/SBTs. At daily huddles, we identified patients eligible for SAT/SBT. The project was received positively by our peers, providers and interdisciplinary team members. We achieved a 39% decrease in total ventilator days and an 85% decrease in VAP and VAE. We also experienced two unintended positive outcomes.