Sedation assessment in critically ill patients under mechanical ventilation in China: a best practice implementation project

INTRODUCTION: Sedation assessment is essential in the management of agitation in ICU patients. Inadequate sedation or oversedation can increase complications, prolong hospital stay, and increase mortality. Correct sedation assessment can reduce the incidence of risk events resulting from inappropriate assessment. OBJECTIVES: This project aimed to promote evidence-based practices for sedation assessment in critically ill patients under mechanical ventilation in the ICU. METHODS: This project was conducted in the comprehensive ICU on two campuses of a tertiary A hospital in Wuxi, Jiangsu Province, China. The project followed the seven-phase JBI Evidence Implementation Framework, which is grounded in an audit and feedback process. Four evidence-based audit criteria were derived from a JBI Best Practice Evidence Summary. Five barriers to best practice were identified and strategies were implemented to improve sedation assessment. Finally, a follow-up audit was conducted to measure changes in compliance with best practices. RESULTS: Project participants included 60y mechanically ventilated patients and 55 health care workers. The results of the follow-up audit showed that compliance with the four audit criteria significantly improved. Notably, compliance for Criterion 1 increased from 0% to 90%, while Criterion 2 and Criterion 4 increased from 86.67% and 72.73% to 100%, respectively. Compliance for Criterion 3 increased from 26.67% to 93.33%. CONCLUSION: The strategies of optimizing intelligent information systems, updating nursing documents, leadership, training, and continuous quality control were helpful in implementing best practice recommendations. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A509.