Evaluation of nurse-directed sedation guidelines for mechanically ventilated patients

 Critically ill patients who need to be mechanically ventilated are usually given sedatives by continuous intravenous infusion but this method of administration has been shown to prolong the duration of mechanical ventilation due to the effects of oversedation. However, the literature from overseas studies has shown that the use of nurse directed sedation guidelines incorporating low rates of continuous intravenous sedatives with sedation scoring, to ensure that sedation is sufficient but not excessive, can reduce the duration of mechanical ventilation. 

This descriptive study evaluated whether patient clinical outcomes could be improved using well designed sedation guidelines for nurses and also assessed the quality of sedation provided with this sedation practice. Clinical outcomes were measured in a group of patients before and after the introduction of the developed sedation guidelines. A convenience sample consisted of adult patients (older than 18 years of age) who were treated on a ventilator for more than 12 hours and received continuous intravenous sedation. 

This study found differences in all the measured clinical outcomes between these two groups. A relatively shorter duration of sedation, weaning time, duration of mechanical ventilation and length of stay ICU were found in the "after" group compared with the outcomes among the "before" group. However, this difference was not statistically significant. These study findings were consistent with the results of previous investigations, which demonstrated a relationship between specific sedation practices and the duration of mechanical ventilation.