Impact of a Real-Time, Pharmacist-Led, Intensive Care Unit-Based Feedback Intervention on Analgesia and Sedation Quality Among Mechanically Ventilated Patients

J Nurs Care Qual. 2021 Jul-Sep;36(3):242-248. doi: 10.1097/NCQ.0000000000000527.

Abstract

Background: Consensus guidelines for pain, agitation, and delirium (PAD) in mechanically ventilated patients recommend maintaining a light level of sedation.

Local problem: Consistent attainment of target PAD assessments in mechanically ventilated ICU patients is often challenging.

Methods: This is a single-center, prospective study.

Interventions: In the intervention group, a pharmacist provided weekly feedback to nurses on their success in achieving target PAD assessments compared with a historical cohort without feedback.

Results: Overall, 478 patients and 205 nurses were included. The odds of having weekly Richmond Agitation-Sedation Scale (RASS) score, pain score goals, and Confusion Assessment Method for the ICU (CAM-ICU) negative assessments at goal between the intervention and control groups fluctuated over time without a discernible trend.

Conclusion: The provision of weekly feedback to nurses on PAD nursing assessments by a pharmacist did not impact the achievement of PAD goals among critically ill mechanically ventilated patients.

MeSH terms

  • Analgesia*
  • Delirium*
  • Feedback
  • Humans
  • Hypnotics and Sedatives
  • Intensive Care Units
  • Pain
  • Pharmacists
  • Prospective Studies
  • Respiration, Artificial

Substances

  • Hypnotics and Sedatives