open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-02-12
Submitted: 2018-01-02
Accepted: 2019-02-09
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Introducing a new sedation policy in a large district general hospital: before and after cohort analysis

Anne Frawley, John Hickey, Christine Weaver, James P Williams, Tamas Szakmany
DOI: 10.5603/AIT.a2019.0004
·
Pubmed: 30747991
·
Anaesthesiol Intensive Ther 2019;51(1):4-10.

open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-02-12
Submitted: 2018-01-02
Accepted: 2019-02-09

Abstract

Background: The management of pain, agitation and sedation for ventilated patients who are admitted to intensive care is an essential part of their care. The introduction of sedation protocols is associated with improved patient outcomes. Methods: We conducted an observational cohort study among mechanically ventilated patients in a 16-bed ICU over a two-year period. We retrospectively examined data from two patient populations, namely those before and after the introduction of a new sedation protocol in July 2015. The primary outcome was the duration of mechanical ventilation in both groups. Results: After the implementation of the new sedation protocol, there was a significant decrease in the mean duration of mechanical ventilation (1.45 days). Furthermore, we observed a non-significant reduction in the mean duration of ICU stay. Conclusion: The new protocol was associated with outcome improvements including: decreased mean duration of mechanical ventilation and a reduced number of ventilated days; and increased patient throughput with a slight increase in the length of vasopressor support. Moreover, the use of a structure-process-outcome model of quality improvement was associated with significant improvements in process measures of quality.

Abstract

Background: The management of pain, agitation and sedation for ventilated patients who are admitted to intensive care is an essential part of their care. The introduction of sedation protocols is associated with improved patient outcomes. Methods: We conducted an observational cohort study among mechanically ventilated patients in a 16-bed ICU over a two-year period. We retrospectively examined data from two patient populations, namely those before and after the introduction of a new sedation protocol in July 2015. The primary outcome was the duration of mechanical ventilation in both groups. Results: After the implementation of the new sedation protocol, there was a significant decrease in the mean duration of mechanical ventilation (1.45 days). Furthermore, we observed a non-significant reduction in the mean duration of ICU stay. Conclusion: The new protocol was associated with outcome improvements including: decreased mean duration of mechanical ventilation and a reduced number of ventilated days; and increased patient throughput with a slight increase in the length of vasopressor support. Moreover, the use of a structure-process-outcome model of quality improvement was associated with significant improvements in process measures of quality.
Get Citation

Keywords

sedation; quality improvement; mechanical ventilation

About this article
Title

Introducing a new sedation policy in a large district general hospital: before and after cohort analysis

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 51, No 1 (2019)

Pages

4-10

Published online

2019-02-12

DOI

10.5603/AIT.a2019.0004

Pubmed

30747991

Bibliographic record

Anaesthesiol Intensive Ther 2019;51(1):4-10.

Keywords

sedation
quality improvement
mechanical ventilation

Authors

Anne Frawley
John Hickey
Christine Weaver
James P Williams
Tamas Szakmany

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