title: Successful Implementation of an Automated Sedation Vacation Process in Intensive Care Units.
abstract: This quality improvement initiative sought to develop a sedation vacation (SV) protocol to increase SV performance and ensure sustainability. A standardized, nurse-driven SV protocol within the electronic medical record was implemented in adult intensive care units (ICUs) at Boston Medical Center. For 6 months, data were collected on the number of assessments performed, SV completion, SV eligibility, and reason for exclusion. Secondary outcomes included ICU length of stay (LOS) and ventilator LOS. Of 1730 patient-days during this 6-month period, SV assessments were performed 70% (n = 1211) of the time. SVs were conducted on 60.0% (n = 726) during days in which an assessment occurred. There was no significant change in ICU LOS or ventilator LOS during the study period. This SV protocol attained a 70% adherence rate, which was sustained over the 6-month period. There were no significant changes in secondary outcomes.
authors.affiliation: Boston Medical Center, Boston, MA Boston University School of Medicine, Boston, MA.
authors.forename: Jason
authors.initials: J
authors.lastname: Ackrivo
authors.affiliation: Boston Medical Center, Boston, MA Kevin.Horbowicz@bmc.org.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Horbowicz
authors.affiliation: Vidant Medical Center, Greenville, NC.
authors.forename: Jason
authors.initials: J
authors.lastname: Mordino
authors.affiliation: Boston Medical Center, Boston, MA.
authors.forename: Maryam
authors.initials: M
authors.lastname: El Kherba
authors.affiliation: Boston Medical Center, Boston, MA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ellingwood
authors.affiliation: Boston Medical Center, Boston, MA Boston University School of Medicine, Boston, MA.
authors.forename: Karin
authors.initials: K
authors.lastname: Sloan
authors.affiliation: Boston Medical Center, Boston, MA Boston University School of Medicine, Boston, MA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Murphy
mesh_terms: D016292:Procedural Sedation / Q000379:methods*; D004360:Drug Therapy, Computer-Assisted / Q000379:methods; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000627:therapeutic use; D007362:Intensive Care Units / Q000458:organization & administration; D007902:Length of Stay / Q000706:statistics & numerical data; D058996:Quality Improvement / Q000458:organization & administration; D012121:Respiration, Artificial / Q000706:statistics & numerical data
chemical_list: D006993:Hypnotics and Sedatives
keywords: deep sedation; electronic health records; intensive care units; nursing assessment; quality improvement; ventilator weaning