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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/overview-ptsoffventilator-facguide.docx
January 01, 2017 - such as the RASS score and the SAS (Riker Sedation-Agitation Scale). … In addition, delirium can be mistaken for anxiety, and incorrectly treated with sedation. … Slide 24
2014 SHEA Compendium Update
SAY:
If sedation is necessary, interrupt sedation at least … Use continuous sedation if boluses exceed three per hour. … Avoid deep sedation with a Richmond Agitation Sedation Scale (RASS) of -4/-5, as it appears to be harmful
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/sat-sbt-protocol.docx
January 01, 2017 - alone.4 This same technique, often called a readiness-to-wean, “wake up and breathe,” or coordinated sedation … open their eyes, look at their caregiver, squeeze the hand, or put out their tongue3 or can go without sedation … Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. … Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated … Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia.
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/daily-early-mobility-fac-guide.html
February 01, 2017 - It includes information about when the patient was intubated, which sedation scale your unit uses, the … tool focuses on intubation and the assessment of sedation and delirium. … Slide 9: Sedation Scale
Say:
This field is for recording which sedation scale is used on your unit … Sedation Scale, RASS, or the Riker Sedation-Agitation Scale, SAS, some units may not employ either of … these scales or do not use a sedation scale at all.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/measuredesc-dailyearlymobility-facguide.docx
January 01, 2017 - It includes information about when the patient was intubated, which sedation scale your unit uses, the … tool focuses on intubation and the assessment of sedation and delirium. … Slide 8
Sedation Scale
SAY:
This field is for recording which sedation scale is used on your unit. … Slide 9
Sedation Scale
SAY:
While the majority of units will likely use the Richmond Agitation Sedation … or do not use a sedation scale at all.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/sustainability/sustainability-workplan.docx
January 01, 2017 - on and monitor how many of your mechanically ventilated patients receive a RASS (Richmond Agitation-Sedation … Scale) or SAS (Riker Sedation-Agitation Scale) sedation assessment.
7 consecutive days per quarter … collect data on and monitor how many of your mechanically ventilated patients receive a RASS or SAS sedation
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/sat-sbt-protocol.html
January 01, 2017 - If the patient passes the safety screen, all sedatives and analgesics used for sedation are stopped. … their eyes, look at their caregiver, squeeze the hand, or put out their tongue 3 or can go without sedation … Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. … Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated … Effect of a nurse-implemented sedation protocol on the incidence of ventilator-associated pneumonia.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/daily-care-processes-guide.pdf
January 01, 2017 - • Target a sedation level and perform a structured assessment of sedation level using a
validated … sedation scale (e.g., Richmond agitation sedation scale [RASS] or Riker
sedation-agitation scale [SAS … Set a target sedation goal of no or light sedation and
work to achieve that level. … protocol targeting light sedation
and incorporating daily sedation interruptions. … Light sedation targets required provider
education, standard sedation practices with a revised sedation
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/intro-early-mobility-facguide.docx
January 01, 2017 - The second intervention is interrupting daily sedation and minimizing sedative use. … Heavily sedated patients are not able to safely participate in a mobility program, and so targeting light sedation … and interrupting sedation daily enable them to remain alert and cooperative. … Using structured assessments of sedation and delirium through validated scales might more effectively … target light sedation levels for your patient and mitigate and treat delirium.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/overview-ptsoffventilator-slides.pptx
January 01, 2017 - level
Use SAT with validated sedation scale daily
Assess readiness to wean daily with SBT
Assess then … AHRQ Safety Program for Mechanically Ventilated Patients
24
2014 SHEA Compendium Update16
Interrupt sedation … as needed
Use continuous sedation if boluses exceed 3 per hour
Avoid continuous benzodiazepines in most … Overview ‹#›
AHRQ Safety Program for Mechanically Ventilated Patients
26
Interrupt sedation daily … necessary to restart, use lowest dose possible to maintain target level of consciousness
Avoid deep sedation
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/vae/overview-off-ventilator-slides.html
February 01, 2017 - Minimize sedation level.
Use SAT with validated sedation scale daily. … Manage ventilated patients without sedation whenever possible.
16. … Slide 25: 2014 SHEA Compendium Update 16
Interrupt sedation once a day (SAT). … Use continuous sedation if boluses exceed 3 per hour. … Avoid deep sedation; instead, target awake or alert.
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/nurse-early-mobility-protocols-fac-guide.html
January 01, 2017 - : (RASS, SAS), Delirium: (ICDSC,CAM-ICU), Sedation Vacation. … Method for the ICU; ICDSC = Intensive Care Delirium Screening Checklist; RASS = Richmond Agitation-Sedation … Scale; SAS = Sedation-Agitation Scale. … In order to mobilize patients sooner, sedation levels need to be reduced to keep patients lightly sedated … If the patient does not open his or her eyes to verbal stimulation due to the use of sedation-related
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/cusp/action-plan-trip-fac-guide.html
February 01, 2017 - A significant barrier to mobilizing patients occurs when patients are under sedation. … Ask:
What is the current practice related to sedation? … ( Perhaps no order was given to halt sedation. … No assessment was performed to indicate the patient needed lighter sedation.) … How often are daily SATs performed on all patients receiving sedation?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/nursedr-early-mobility-protocols-slides.pptx
January 01, 2017 - Delirium
Multidisciplinary
Approach
Ventilator Weaning
Sedation Vacation
(RASS, SAS)
(ICDSC, CAM-ICU … Method for the ICU; ICDSC = Intensive Care Delirium Screening Checklist; RASS = Richmond Agitation-Sedation … Scale; SAS = Sedation-Agitation Scale
Nurse-Driven Early Mobility ‹#›
AHRQ Safety Program for Mechanically … Sedation, delirium, and mechanical ventilation: the “ABCDE” approach. … Sedation, delirium, and mechanical ventilation: the “ABCDE” approach.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/early-mobility-mvpguide.pdf
January 01, 2017 - • Structured assessments of sedation level and delirium using sedation and delirium
scales. … rounds and the actual sedation level of patients. … In order to demonstrate
this, we tracked the agreed-upon sedation level and the actual sedation level … • Excessive sedation. … level and perform structured assessment of sedation level using a
sedation scale
• Perform a structured
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/intro-early-mobility-fac-guide.html
February 01, 2017 - The second intervention is interrupting daily sedation and minimizing sedative use. … and interrupting sedation daily enable them to remain alert and cooperative. … Using structured assessments of sedation and delirium through validated scales might more effectively … target light sedation levels for your patient and mitigate and treat delirium. … therapists in the units, EM remains uncommon among mechanically ventilated patients with intubation and sedation
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/sustainability/workplan.html
January 01, 2017 - on and monitor how many of your mechanically ventilated patients receive a RASS (Richmond Agitation-Sedation … Scale) or SAS (Riker Sedation-Agitation Scale) sedation assessment.
7 consecutive days per quarter … collect data on and monitor how many of your mechanically ventilated patients receive a RASS or SAS sedation
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/actionplan-trip-facguide.docx
January 01, 2017 - A significant barrier to mobilizing patients occurs when patients are under sedation. … ASK:
What is the current practice related to sedation? … (Perhaps no order was given to halt sedation. … No assessment was performed to indicate the patient needed lighter sedation.) … How often are daily SATs performed on all patients receiving sedation?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/intro-early-mobility-slides.pptx
January 01, 2017 - physical, occupational, and respiratory therapists; physicians; and administrators
Interrupt daily sedation … and minimize sedative use
Daily sedative interruptions and targeting light sedation will help patients … remain alert and cooperative
Assess sedation and delirium with structured scales
Routinely assessing … the patient’s cognitive function helps target lighter sedation levels and treat delirium
Screen for … were main barriers
Endotracheal tube Sedation Inotropes Femoral
Line Respiratory
Rate Pulmonary Artery
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/sustainability/sustainability-checklist.docx
January 01, 2017 - head of the bed is at least 30 degrees from the horizontal position
Daily*
Continue to conduct a sedation … receiving a spontaneous breathing trial (SBT)
Daily*
Daily Early Mobility
Continue to conduct a sedation
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/datameasures-guide.pdf
January 01, 2017 - Sedation Scale Definitions .......................................................................... … Sedation Scale Definitions
RATE FACTOR DETAILED DESCRIPTION
Sedation Scale
Percentage of
RASS/SAS … levels
Sedation Scale:
Light to Moderate
Sedation (RASS
Actual = {-2, -3} or
SAS Actual = {3 … SBT Definitions
Sedation Scale
Table 5. … Sedation Scale Definitions
Delirium Assessment
Table 6.