Intensive Care Medicine

, Volume 32, Issue 10, pp 1506–1514

The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit

  • Rosalind Elliott
  • Sharon McKinley
  • Leanne M. Aitken
  • Joan Hendrikz
Original
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Abstract

Objective

To examine the effect of an algorithm-based sedation guideline developed in a North American intensive care unit (ICU) on the duration of mechanical ventilation of patients in an Australian ICU.

Design and setting

The intervention was tested in a pre-intervention, post-intervention comparative investigation in a 14-bed adult intensive care unit.

Patients

Adult mechanically ventilated patients were selected consecutively (n = 322). The pre-intervention and post-intervention groups were similar except for a higher number of patients with a neurological diagnosis in the pre-intervention group.

Intervention

An algorithm-based sedation guideline including a sedation scale was introduced using a multifaceted implementation strategy.

Measurements and results

The median duration of ventilation was 5.6 days in the post-intervention group, compared with 4.8 days for the pre-intervention group (P = 0.99). The length of stay was 8.2 days in the post-intervention group versus 7.1 days in the pre-intervention group (P = 0.04). There were no statistically significant differences for the other secondary outcomes, including the score on the Experience of Treatment in ICU 7 item questionnaire, number of tracheostomies and number of self-extubations. Records of compliance to recording the sedation score during both phases revealed that patients were slightly more deeply sedated when the guideline was used.

Conclusions

The use of the algorithm-based sedation guideline did not reduce duration of mechanical ventilation in the setting of this study.

Keywords

Intensive care Mechanical ventilation Clinical practice guideline Sedation Nursing 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Rosalind Elliott
    • 1
  • Sharon McKinley
    • 2
  • Leanne M. Aitken
    • 3
  • Joan Hendrikz
    • 4
  1. 1.Intensive Care UnitThe Royal North Shore HospitalSydneyAustralia
  2. 2.Critical Care Nursing, Intensive Care UnitThe Royal North Shore Hospital and The University of TechnologySydneyAustralia
  3. 3.Critical Care Nursing, Research Centre for Clinical Practice InnovationGriffith University and Princess Alexandra HospitalBrisbaneAustralia
  4. 4.Statistics, CONROD, Mayne Medical CentreThe University of QueenslandBrisbaneAustralia

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