Application Of A Local Sedation Nursing Protocol In Mechanical Ventilated Patients In ICU

ObjectiveTo describe the mastery of Shanghai third-level general hospital ICU nurses’ sedation knowledge of the mechanical ventilation and its influencing factors. To describe the nursing practice of the mechanical ventilation in ICU of Shanghai third-level general hospitals. To evaluate the effects of a local sedation nursing protocol in mechanical ventilated patients in ICU by sedation depth, duration of mechanical ventilation, length of days in the ICU, length of days in hospital, and the incidence of adverse events related to sedation.MethodsThere were two stages included in this study. The first stage:A cross-sectional study design was conducted in this stage. A stratified sampling of133ICU nurses in14third-level general hospitals in Shanghai according to years of intensive care unit work was selected. Questionnaire of sedation knowledge of the mechanical ventilation and sedation nursing practice of the mechanical ventilation was used to survey. The second stage:A quasi-experimental study design was conducted in this stage. Comparing the sedation effects and incidence of adverse events related to sedation before and after application of a local sedation protocol refer to staff training, standardized form design, daily sedation goal setting, standardized assessment and record.Results1. The average knowledge score of mechanical ventilation sedation in ICU nurses was10.74±1.94, the dimension from good to bad:basic care, relationship to analgesia, sedation assessment, the adjustment of pump speed, the sedative side effects, sedation goals, indications, and the way of administration. Knowledge of sedation was related to whether or not to accept the sedation knowledge training and qualifications.2.19.55%of the nurses in intensive care unit where routine to carry out the sedation in mechanically ventilated patients;70.68%administered sedative drugs using continuous infusion;52.63%ICU had individualized sedation goals, and can be dynamically adjusted;51.88%of sedation scores were assessed by doctors,28.57%use the scoring tool;27.07%using the Ramsay sedation score;19.55%of patients were in incorrect sedation;57.14%of nurses have not received systematic training about sedation.3. After intervention, patients have lower sedation score and shorter hospital stay (P<0.05). There is no difference in the length of days in ICU and catheterization, and the incidence of adverse events related to sedation.Conclusion1. Nurses’knowledge to sedative is not optimistic. ICU nurses should be trained and given standard operating procedures to ensure the good effect of sedation.2. Sedation practice among mechanical ventilation patients in ICU of Shanghai third-level general hospitals still had some deficiency, thus more attention should be paid to staff training and establishing local clinical practice guidelines for the sustained use of sedatives.3. Local sedation nursing protocol can improve both process and outcome indicators of sedation effects.