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.
Lord, Jannette, "Improving Sedation Management in Mechanically Ventilated Patients" (2020). Walden Dissertations and Doctoral Studies. 8400.