Evidence-based Decision Making
Scenario: Healthcare Organization is Long term acute care hospital (LTACH). Patient population average age 30-90 years, mainly with respiratory distress (including vents/trach), critical drips, extensive wounds (wound vacs) with minimum stay of 23 days.
PICOT question: In mechanical ventilated patients does daily sedation interruptions compared to continuous sedation improve patient outcomes over a thirty-day hospital stay.
FOUR ARTICLES CHOSEN FROM UNIVERSITY’S DATABASE
Vagionas, D., Vasileiadis, I., Rovina, N., Alevrakis, E., Koutsoukou, A., & Koulouris, N. (2019). Daily sedation interruption and mechanical ventilation weaning: A literature review. Anaesthesiology Intensive Therapy, 51(5), 380–389. https://doi.org/10.5114/ait.2019.90921
Kayir, S., ULUSOY, H., & Dogan, G. (2018). The effect of daily sedation-weaning application on morbidity and mortality in intensive care unit patients. Cureus. https://doi.org/10.7759/cureus.2062
Yousefi, H., Shahabi, M., Yazdannik, A. R., & Alikiaii, B. (2016). The effect of daily sedation interruption protocol on early incidence of ventilator-associated pneumonia among patients hospitalized in critical care units receiving mechanical ventilation. Iranian Journal of Nursing and Midwifery Research, 21(5), 541. https://doi.org/10.4103/1735-9066.193420
Kallet, R. H., Zhuo, H., Yip, V., Gomez, A., & Lipnick, M. S. (2017). Spontaneous breathing trials and conservative sedation practices reduce mechanical ventilation duration in subjects with Ards. Respiratory Care, 63(1), 1–10. https://doi.org/10.4187/respcare.05270
ASSIGNMENT: I HAVE CHOSEN THE FOUR ARTICLES LISTED BELOW. THE ANSWERS TO THE QUESTIONS BELOW SHOULD BE FOR EACH ARTICLE INCLUDED AND RELATES TO MY PICOT QUESTION.
Clinical Issue: PICOT: In mechanical ventilated patients does daily sedation interruptions compared to continuous sedation improve patient outcomes over a three-month hospital stay
Clinical issue of interest: implementation of daily sedation interruption in mechanical ventilated patients.
Healthcare Organization: Select Specialty Hospital, Augusta GA.
To complete this Assessment:
- Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
- Identify a clinical issue of interest that can form the basis of an evidence-based change.
Create a 10- to 13-slide narrated PowerPoint presentation in which you address the following:
- Explain the clinical issue of interest that is most conducive to an evidence-based practice change in your healthcare organization. (1–2 slides)
- Describe the evidence-based practice change that you would recommend implementing to address the clinical issue of interest that you selected. Be specific and provide examples. (2–3 slides)
- Compare at least two dissemination strategies that you might recommend to communicate evidence-based practice changes to your organization and explain why. (2 slides)
- Compare at least two dissemination strategies that you would be least inclined to recommend to communicate evidence-based practice changes to your organization and explain why. (2 slides)
- Identify at least two barriers that you might encounter when using the dissemination strategies that you are most inclined to use. (1 slide)
- Explain how you might overcome the barriers that you identified. Be specific and provide examples. (2–3 slides)