Date of Award

Summer 2025

Project Type

Thesis

Department

Nursing

Program or Major

Direct Entry Masters of Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Second Advisor

Elizabeth Evans

Abstract

Abstract

BACKGROUND

Mechanically ventilated ICU patents often require sedation for comfort and ventilator compliance. However, oversedation is linked to negative outcomes such as delirium, prolonged ventilation, and increased duration of ICU stay. Current best practices now support the use of daily sedation interruptions such as Spontaneous Awakening Trials (SATs). Despite these recommendations, implementation of SATs remain inconsistent and suboptimal.

LOCAL PROBLEM:

Within the ICU in a northern new England hospital, there was a need to improve nurse confidence and knowledge in SATs practices through staff education.

METHODS:

Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was developed to improve and assess ICU nurses’ knowledge and confidence in SATs. The plan phase was complete in May by identifying and gathering information of the problem and conduction a literature review. The do phase was completed in July and included distribution of pre- and post-survey as well as the educational intervention. The study phase was completed in July including analyzing the data collected to determine effect of educational intervention on SATs knowledge and confidence.

INTERVENTION:

A brief, targeted educational session was created and delivery to ICU nursing staff electronically. Pre- and post-intervention surveys using multiple-choice, select all that apply, and Likert-scale questions were used to assess for changes in knowledge and confidence related to SATs.

RESULTS:

Pre-intervention knowledge data showed a mean correct response of 0.87 compared to a mean correct post-intervention response of 0.95 (change of +0.08). Confidence scores increased to a mean of 4.25 in nursing role in conducting and supporting a SATs compared to a mean of 3.88 in the pre-intervention survey (change = +0.42). Multiple barriers to SATs implementation were expressed such as lack of formal protocol, lack of staff, and low multidisciplinary buy-in.

CONCLUSION

The educational intervention did not meet the specific aims of this project but was associated with improved overall knowledge scores and confidence in nursing role during SATs. While further evaluation is needed to determine its impact on clinical practice, the results suggest that targeted, evidence-based education can be an effective strategy to improve knowledge gaps and confidence in SATs. This approach may be useful in other areas where similar educational needs exist.

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