Spontaneous awakening trial structure in the ICU: Changing the culture of ventilator weaning
Title
Spontaneous awakening trial structure in the ICU: Changing the culture of ventilator weaning
Creator
Zyniecki, Catherine
Description
Zyniecki, Catherine
The Institute for Healthcare Improvement (IHI) developed the concept of best practice bundles as a way to align people, processes and technology from multiple disciplines to provide effective, evidence based care. Researchers from Vanderbilt University created the ABCDEF bundle as a multidisciplinary process to ventilator weaning based on best evidence. The purpose of this quality improvement project is to change the culture of ventilator weaning in an ICU by educating nurses about the importance of Richmond Agitation Sedation Scale (RASS) target scores in relation to a consistent and systematic method of performing spontaneous awakening trials (SAT) of ventilated patients. A 24 bed, intensive care unit in a mid-sized, urban hospital was the setting for this project. The theories of Dorothea Orem, Kurt Lewin and the adult learning principles of Malcom Knowles as well as the VARK learning strategies were used to guide the development and implementation. This project evaluated the effectiveness of a multi-educational teaching strategy in the implementation of SAT in relation to the use of minimal sedation in ventilator assisted patients that are weaning. The impact made by CNS led education and bedside support with goal RASS, physical therapy and SAT during the weaning process was measured in comparison with the ABCDEF bundle guidelines. The results of this quality improvement project show a change in nursing practice as evidenced by improvements in RASS scores to within goal, head of bed up and lights on during weaning, physical therapy ordered before extubation and nurses performing SAT before spontaneous breathing trials are attempted. Keywords: best practice bundles, spontaneous awakening trials, Orem, Lewin, Knowles
The Institute for Healthcare Improvement (IHI) developed the concept of best practice bundles as a way to align people, processes and technology from multiple disciplines to provide effective, evidence based care. Researchers from Vanderbilt University created the ABCDEF bundle as a multidisciplinary process to ventilator weaning based on best evidence. The purpose of this quality improvement project is to change the culture of ventilator weaning in an ICU by educating nurses about the importance of Richmond Agitation Sedation Scale (RASS) target scores in relation to a consistent and systematic method of performing spontaneous awakening trials (SAT) of ventilated patients. A 24 bed, intensive care unit in a mid-sized, urban hospital was the setting for this project. The theories of Dorothea Orem, Kurt Lewin and the adult learning principles of Malcom Knowles as well as the VARK learning strategies were used to guide the development and implementation. This project evaluated the effectiveness of a multi-educational teaching strategy in the implementation of SAT in relation to the use of minimal sedation in ventilator assisted patients that are weaning. The impact made by CNS led education and bedside support with goal RASS, physical therapy and SAT during the weaning process was measured in comparison with the ABCDEF bundle guidelines. The results of this quality improvement project show a change in nursing practice as evidenced by improvements in RASS scores to within goal, head of bed up and lights on during weaning, physical therapy ordered before extubation and nurses performing SAT before spontaneous breathing trials are attempted. Keywords: best practice bundles, spontaneous awakening trials, Orem, Lewin, Knowles
Date
2015
Publisher
Alverno College
Extent
54 pages
Language
English
Format
PDF
Type
Text
Capstone Project
Rights
These materials may be used by individuals and libraries for personal use, research, teaching (including distribution to classes), or for any fair use as defined by U.S. Copyright Law.
Collection
Citation
Zyniecki, Catherine, “Spontaneous awakening trial structure in the ICU: Changing the culture of ventilator weaning,” Alverno College Library Digital Commons, accessed May 13, 2025, https://alverno.omeka.net/items/show/681.