Date of Conferral



Doctor of Nursing Practice (DNP)




Dr. Barbara A. Niedz



In the intensive care unit (ICU), sedation management of the critically ill, mechanically

ventilated patient is a source of concern. Optimal sedation management is integral to

critical care practice, yet optimal levels of sedation are not consistently applied.

Suboptimal sedation carries significant risks for patients, as inadequate sedation or

oversedation may lead to prolonged ventilator days, ventilator-associated pneumonia

(VAP), extended length of ICU stay, and costs. The purpose of this quality improvement

(QI) project was to improve sedation management of mechanically ventilated patients by

improving staff nurses’ knowledge of and attitudes toward sedation management,

ultimately achieving a zero-ventilated associated pneumonia rate. The Institute for

Healthcare Improvement QI model provided the framework for the study. The practice

focused question guiding the project concerned whether nurses’ knowledge and attitudes

would improve after participation in an educational module, and whether implemented

strategies would improve outcomes in the cardiovascular ICU. An online education

module with face-to-face debriefing aimed at addressing sedation management was used.

Pre- and posttest results demonstrated a change in knowledge acquisition (t = 9.251, df =

29, p=.000). A positive change in attitudes was indicated in the qualitative debriefing as

nurses appreciated the value of preventing VAP without oversedation and brainstormed

ways to overcome barriers. Most importantly, there were zero incidents of VAP in the 8

weeks following the educational process and debriefing discussions. Clinical implications

of this QI project are that an educational process can help nurses find the means to

provide optimal sedation management and to prevent negative consequences of

oversedation, which would constitute positive social change.

Included in

Nursing Commons