Abstract Introduction/Rationale Light sedation is associated with better outcomes than deep sedation among mechanically ventilated patients in the intensive care unit (ICU) and is recommended by society guidelines. However, recent evidence suggests declining adherence to light sedation practices, particularly after the COVID-19 pandemic. Nursing staff play a crucial role in the level of sedation patients experience while mechanically ventilated. Therefore, we sought to characterize the baseline knowledge of ICU nurses regarding appropriate pain, sedation, and delirium practices, as well as assess their perceptions regarding quality improvement (QI) initiatives in the ICU. Methods The nursing staff of two medical ICUs at a quaternary academic medical center were administered online education modules focused on evidence-based practice for management of pain, sedation, and delirium in the ICU. Modules were clinical case-based and contained both narrated educational videos and gamified questions intended to assess baseline knowledge of the topics. A survey was administered before the modules to assess readiness and perceived barriers to implementing QI initiatives in the ICU. Results A total of 139 registered nurses completed the surveys and modules. Module responses suggested a mild knowledge gap with 68.5% (standard deviation (SD)=21.2%) of analgesia questions, 70.5% (SD = 21.6%) of sedation questions, and 84.9% (SD = 19.7%) of delirium questions answered correctly. Moderate to major barriers to implementing QI initiatives were reported as sufficient time (63.4%), other issues with higher priority (53.1%), staff commitment (40.9%), and physician commitment (34.1%). Communication between disciplines was also identified as a moderate to major barrier by 34.7% of respondents. Department leadership (92.1%), hospital leadership (76.2%), and evidence of value of intervention (80.5%) were reported as minor to no barrier. The majority of respondents (79.2%) reported feeling their team prioritizes implementation of evidence-based practice, and 72.5% reported they were confident they could effectively participate in ICU QI initiatives. Conclusions ICU nursing staff demonstrated moderate conceptual knowledge in best practice of pain, sedation, and delirium management. They also expressed readiness to align practice with evidence-based medicine. However, previous work by our group and others has demonstrated gaps in the adherence to these best practices. Thus, significant opportunity exists to leverage implementation approaches to facilitate application of best practice in ICU pain, sedation, and delirium management. This abstract is funded by: Office for the Advancement of Telehealth
Easterling et al. (Fri,) studied this question.