Activity Summary
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.
Objectives
- Discuss key concepts of a direct care nurse unit change project
- Apply tools and methods shared in their own unit
Continuing Education Disclosure Statement
Continuing Education Recognition Points (CERPs) are recognized by the AACN Certification Corporation, our credentialing arm, to encompass a wide spectrum of continuing education activities performed by nurses in high acuity and critical care and fulfill educational requirements for certification. Synergy CERP is a program exclusive to AACN for nurses wishing to recertify through AACN.
State boards of nursing and other certification organizations may recognize CERPs as meeting CE Contact Hour requirements. We recommend consulting with the state board or credentialing organization before submitting CERPs to fulfill CEContact Hour requirements.