Decreasing Unplanned Extubations: Enhancing Critical Care Nurses' Comprehension in Sedation Pharmacotherapy

Abstract

Purpose: The purpose of this quality improvement (QI) project was to evaluate the effectiveness of an educational QI initiative in improving critical care nurses' understanding of sedation practices and pharmacotherapy, to reduce unplanned extubations (UE) incidence in adult critical care units. Background: In critical care, patients often require invasive mechanical ventilation, exposing them to complications such as UE, considered severe adverse events. These incidents jeopardize patient safety and clinical outcomes (Li et al, 2023). Sedatives are commonly administered alongside mechanical ventilation in adult critical care units. Critical care nurses are essential in managing sedative medications, assessing sedation levels, and preventing UE, playing a critical role in patient care. Methods: A quasi-experimental design was employed at a Banner Health facility, focusing on adult critical care nurses. Pre- and post-surveys were conducted to evaluate participants’ knowledge and practices related to sedation and UE prevention. Surveys assessed understanding of UE risk factors, complications, sedative pharmacodynamics, and safety awareness. Results: Participants showed improved comprehension of sedative pharmacodynamics, particularly with propofol and dexmedetomidine, and increased understanding of sedation practices and safety awareness after the intervention. They unanimously perceived the educational initiative as highly impactful on their clinical practice, effectively enhancing critical care nurses' knowledge of sedation practices and pharmacotherapy, potentially reducing UE incidence, and elevating patient safety standards in adult critical care units.11 Conclusions: The QI project effectively strengthened critical care nurses' understanding of sedation practices and pharmacotherapy, likely lowering UE rates, and enhancing patient safety and outcomes in adult critical care settings.