Date of Award
Summer 2026
Abstract
Abstract
Background: Spontaneous Awakening Trails (SATs) and Spontaneous Breathing Trials (SBTs) are key components of the ICU Liberation Bundle and have been associated with shorter durations of mechanical ventilation, reduced intensive care unit (ICU) length of stay (LOS), and improvement in patient outcomes. Despite having strong evidence supporting their use, implementation remains inconsistent due to knowledge gaps, workflow barriers and interdisciplinary communication challenges.
Local Problem: This quality improvement (QI) project aimed to improve critical care nurses’ knowledge and confidence regarding the implementation of SATs and SBTs through an evidence-based educational intervention.
Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, this QI project was conducted in the critical care unit of a community hospital in Southern New England. Anonymous electronic pre- and post-intervention surveys assessed nurses’ knowledge, confidence and perceived barriers related to SAT and SBT implementation. Following analysis of baseline survey findings, an evidence-based educational handout summarizing SAT and SBT indications, contraindications, and best practices was distributed electronically. Descriptive statistics were used to compare pre- and post-intervention survey responses.
Results: Eleven nurses completed the pre-intervention survey and three completed the post-intervention survey. Baseline knowledge was high across most survey items, with improvements observed in identifying hemodynamic instability and assessment of hemodynamic stability before SBTs following the educational intervention. Participants continued to identify workflow and interdisciplinary communication as barriers to consistent SAT and SBT implementation. Findings should be interpreted cautiously because of the limited post-intervention response.
Conclusion: This project demonstrated the feasibility of implementing a low-cost educational intervention to reinforce evidence-based SAT and SBT practices. Continued staff education, interdisciplinary collaboration, and integration of SAT and SBT protocols into routine ICU workflows may improve adherence to ICU Liberation Bundle Recommendations and support future improvements in patient outcomes.
Document Type
Master's Thesis
First Advisor
Pam Kallmerten
Second Advisor
Elizabeth Evans
College or School
CHHS
Department or Program
Direct Entry Masters in Nursing
Degree Name
Master of Science
Recommended Citation
Crapo, Morgan, "Improving Staff Knowledge and Consistency in SAT and SBT Practices in the Critical Care Unit: A Quality Improvement Initiative" (2026). Master's Theses and Capstones. 2098.
https://scholars.unh.edu/thesis/2098