title: Effects of nurses' practice of a sedation protocol on sedation and consciousness levels of patients on mechanical ventilation.
abstract: BACKGROUND
  Providing high-quality care in the intensive care units (ICUs) is a major goal of every medical system. Nurses play a crucial role in achieving this goal. One of the most important responsibilities of nurses is sedation and pain control of patients. The present study tried to assess the effect of nurses' practice of a sedation protocol on sedation and consciousness levels and the doses of sedatives and analgesics in the ICU patients.
  
  
  METHODS
  This clinical trial was conducted on 132 ICU patients on mechanical ventilation. The patients were randomly allocated to two groups. While the control group received the ICU's routine care, the intervention group was sedated by ICU nurses based on Jacob's modified sedation protocol. The subjects' sedation and consciousness levels were evaluated by the Richmond Agitation Sedation Scale (RASS) and the Glasgow Coma Scale (GCS), respectively. Doses of administered midazolam and morphine were also recorded.
  
  
  RESULTS
  The mean RASS score of the intervention group was closer to the ideal range (-1 to +1), compared to the control group (-0.95 ± 0.3 vs. -1.88 ± 0.4). Consciousness level of the control group was lower than that of the intervention group (8.4 ± 0.4 vs. 8.8 ± 0.4). Finally, higher doses of midazolam and morphine were administered in the control group than in the intervention group.
  
  
  CONCLUSIONS
  As nurses are in constant contact with the ICU patients, their practice of a sedation protocol can result in better sedation and pain control in the patients and reduce the administered doses of sedatives and analgesics.
authors.affiliation: Department of Medical and Surgical Nursing, School of Nursing, Kerman University of Medical Science, Kerman, Iran.
authors.forename: Mohammad Esmaeili
authors.initials: ME
authors.lastname: Abdar
authors.affiliation: Department of Intensive and Critical Care Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Science, Shahrekord, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Rafiei
authors.affiliation: Department of Medical and Surgical Nursing, School of Nursing, Kerman University of Medical Science, Kerman, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Abbaszade
authors.affiliation: Department of Medical and Surgical Nursing, School of Nursing, Kerman University of Medical Science, Kerman, Iran.
authors.forename: Hakimeh
authors.initials: H
authors.lastname: Hosseinrezaei
authors.affiliation: Department of Clinical Research, Kerman Medical University Research Center, Kerman University of Medical Science, Kerman, Iran.
authors.forename: Zahra Esmaeili
authors.initials: ZE
authors.lastname: Abdar
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Shahrekord University of Medical Science, Shahrekord, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Delaram
authors.affiliation: Department of Intensive and Critical Care Medicine, School of Medicine, Kerman University of Medical Science, Kerman, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ahmadinejad
keywords: Consciousness level; nurse; pain; sedation; sedation protocol