Staff education, regular sedation and analgesia quality feedback, and a sedation monitoring technology for improving sedation and analgesia quality for critically ill, mechanically ventilated patients: a cluster randomised trial.

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Abstract

Optimal sedation of patients in intensive care units (ICUs) requires the avoidance of pain, agitation, and unnecessary deep sedation, but these outcomes are challenging to achieve. Excessive sedation can prolong ICU stay, whereas light sedation can increase pain and frightening memories, which are commonly recalled by ICU survivors. We aimed to assess the effectiveness of three interventions to improve sedation and analgesia quality: an online education programme; regular feedback of sedation-analgesia quality data; and use of a novel sedation-monitoring technology (the Responsiveness Index [RI]).

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Journal

Journal ID (iso-abbrev): Lancet Respir Med

Title: The Lancet. Respiratory medicine

Publisher: Elsevier BV

ISSN (Electronic): 2213-2619

ISSN (Print): 2213-2600

Publication date (Electronic): October 2016

Volume: 4

Issue: 10

Affiliations

[1 ] Anaesthetics, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, Scotland, UK. Electronic address: twalsh@staffmail.ed.ac.uk.

[2 ] Anaesthetics, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, Scotland, UK; Edinburgh Napier University, Edinburgh, Scotland, UK.

[3 ] Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, Scotland, UK.

[4 ] Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK.

[5 ] Anaesthetics, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, Scotland, UK.

[6 ] Edinburgh Napier University, Edinburgh, Scotland, UK; Edinburgh Health Services Research Unit, Edinburgh, Scotland, UK.

[7 ] GE Healthcare Finland Oy, Kuortaneenkatu 2, 00510 Helsinki, Finland.

[8 ] Department of Anaesthetics, Ninewells Hospital, NHS Tayside, Scotland, UK.

[9 ] University Department of Anaesthetics, Glasgow University, Glasgow Royal Infirmary, Glasgow, Scotland, UK.

[10 ] Department of Anaesthetics, Monklands Hospital, NHS Lanarkshire, Scotland, UK.

[11 ] Department of Anaesthetics, Victoria Hospital, Kirkcaldy, NHS Fife, Scotland, UK.

[12 ] Department of Anaesthetics, Victoria Infirmary, NHS GGC, Glasgow, Scotland, UK.

[13 ] Department of Anaesthetics, Dumfries and Galloway Royal Infirmary, NHS Dumfries and Galloway, Scotland, UK.

[14 ] Department of Anaesthetics, Forth Valley Royal Hospital, NHS Forth Valley, Scotland, UK.

[15 ] Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK; Edinburgh Health Services Research Unit, Edinburgh, Scotland, UK.

Article

Publisher Item ID: S2213-2600(16)30178-3

DOI: 10.1016/S2213-2600(16)30178-3

PubMed ID: 27473760

SO-VID: b3f038fd-67fc-45e5-8d47-ede5f39e3d15

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