Evaluation of the Spontaneous Awakening Trial Protocol: Staff Nurse Facilitators and Barriers to Compliance
Creators:Wahlrab, Lisa A.
Advisor:Loversidge, Jacqueline M.
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Every year 5.7 million people are admitted to an intensive care unit (ICU). Many of these patients require continuous sedation to tolerate invasive life support methods necessary for their care. Continuous sedation has been shown to lead to negative outcomes such as increases in duration of mechanical ventilation, length of stay, morbidity, and mortality. Recent research has shown that utilizing a spontaneous awakening trial, or SAT, can improve patient outcomes through decreases in duration of mechanical ventilation, decreases in ICU length of stay, and decreases in morbidity and mortality. The surgical intensive care unit at this institution has documented low compliance with a SAT protocol. This low compliance could be leading to increases in duration of mechanical ventilation and poor outcomes for these patients. Focus groups comprised of bedside nurses were utilized to explore the possible reasons behind low compliance. Four focus groups took place over the course of one week with 17 total nurse participants. The focus groups were recorded and transcribed. Transcriptions were analyzed for themes using a classic analysis strategy. Three themes emerged from the analysis. These themes included a lack of awareness of the SAT protocol, a lack of continuing education regarding a SAT protocol, and a lack of understanding of the benefits of a SAT protocol. Several suggestions were made to combat these issues including the use of nurse champions and an interdisciplinary group to re-work the protocol and form a continuing education program for staff. Ideally these tools can help increase knowledge of and compliance with the SAT protocol in order to improve patient outcomes.
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