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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/actionplan-trip-slides.pptx
January 01, 2017 - Engage
Educate
Execute
Evaluate
Elevate head of bed 30°
Use subglottic endotracheal tubes
Minimize sedation … reporting—so we could be inadequately identifying and/or managing pain; our order set for continuous sedation … reporting—so we could be inadequately identifying and/or managing pain; our order set for continuous sedation … Action Plan ‹#›
AHRQ Safety Program for Mechanically Ventilated Patients
Unit-Based Gap Analysis3
Sedation … , and Delirium guidelines
We routinely perform both pain and sedation assessment on patients using a
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-206-fullreport.pdf
November 01, 2019 - Children are also at
risk for complications from sedation or anesthesia, which are often required for … Sedation- and Anesthesia-Related Burden and Risk
Some children will require sedation to ensure minimal … Compared with minimal sedation, moderate and deep sedation carry a greater risk
of airway compromise … Anaesthesia or sedation for paediatric MRI: Advantages and disadvantages. … operating room: Report from the Pediatric
Sedation Research Consortium.
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/intro-early-mobility-slides.html
February 01, 2017 - Interrupt daily sedation and minimize sedative use:
Daily sedative interruptions and targeting light … sedation will help patients remain alert and cooperative. … helps target lighter sedation levels and treat delirium. … Slide 15: PT Reported Barriers to Early Mobilization 4
Intubation and sedation were main barriers … Sedation is the most common barrier.
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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-facguide.docx
January 01, 2017 - By viewing sedation and delirium management and ventilator weaning through the lenses of a multidisciplinary … In order to mobilize patients sooner, sedation levels need to be reduced to keep patients lightly sedated … refers to conducting spontaneous awakening trials and spontaneous breathing trials; choosing light sedation … to a primary central nervous system, or CNS, etiology or unstable intracranial pressure, or due to a sedation-related … 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/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/4es-early-mobility-facguide.docx
January 01, 2017 - Another example may be that an order set for continuous sedation has a Richmond Agitation Sedation Scale … It is therefore important to educate your interdisciplinary staff about continuous versus bolus sedation … and to standardize your approach to sedation management. … Patient factors consist of the following: sedation level, breathing support for early mobility intervention … This tool will enable you to track your management of sedation and delirium levels, your perceived barriers
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/4es-early-mobility-slides.pptx
January 01, 2017 - STRATEGY TO OVERCOME BARRIER
Oversedation Educate interdisciplinary staff about continuous versus bolus sedation … Standardize approach to sedation management
Delirium Screen with validated assessment tool
Minimize … Program for Mechanically Ventilated Patients
Readiness Assessment: Other Considerations
Patient factors
Sedation … mobility
Bed rest orders
Patient on comfort/palliative care measures
Patient sedated (Richmond Agitation-Sedation … Score [RASS] -4 or -5; or Riker Sedation-Agitation Scale [SAS] 1 or 2) and on infusion of benzodiazepine
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Patterson_48.pdf
May 05, 2008 - domain has been used to design a high-
reliability sedation/analgesia care microsystem. … • Establishing privileges for sedation with explicit competencies.
14
• Correcting deficits … • Establishing a specific simulation-based sedation rescue training intervention. … to other sedation services. … These changes resulted in improvements in:
• Pain/sedation management.
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/4es-early-mobility-slides.html
February 01, 2017 - 2
Oversedation:
Educate interdisciplinary staff about continuous versus bolus sedation. … Standardize approach to sedation management.
Delirium:
Screen with validated assessment tool. … Slide 17: Readiness Assessment: Other Considerations
Patient factors:
Sedation level. … Patient sedated (Richmond Agitation-Sedation Score [RASS] -4 or -5; or Riker Sedation-Agitation Scale
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/sustainability/sustainability-scorecard.docx
January 01, 2017 - or more
How many of your mechanically ventilated patients received a RASS (Richmond Agitation-Sedation … Scale) or SAS (Sedation-Agitation Scale) assessment?
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ce.effectivehealthcare.ahrq.gov/research/findings/factsheets/children/new-starts/2011.html
October 01, 2014 - Society for Pediatric Sedation Consensus Meeting: Defining Quality in Pediatric Sedation. J. … Michael Connors, MD, Principal Investigator; Society for Pediatric Sedation, Richmond, VA. … This project provides support for an expert meeting of multidisciplinary sedation providers to begin … the process of defining quality as it relates to the field of pediatric sedation. … of established protocols and practices related to pediatric sedation needed to establish quality benchmarks
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/sustainability/communication-strategies-slides.html
February 01, 2017 - SEDATION: Minimize sedation level.
DELIRIUM: Assess then address delirium. … Early Mobility—
SEDATION: Minimize sedation level.
DELIRIUM: Assess then address delirium.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallpxtoolkit/fallpxtool5a.docx
January 29, 2013 - Patient factors
Mental state
Identify those patients most vulnerable to falls because of sedation,
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/4es-early-mobility-facguide.html
February 01, 2017 - Another example may be that an order set for continuous sedation has a Richmond Agitation Sedation Scale … It is therefore important to educate your interdisciplinary staff about continuous versus bolus sedation … and to standardize your approach to sedation management. … Patient factors consist of the following: sedation level, breathing support for early mobility intervention … This tool will enable you to track your management of sedation and delirium levels, your perceived barriers
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallprevention-training/module5/module5_tools.docx
August 03, 2017 - Patient factors
Mental state
Identify those patients most vulnerable to falls because of sedation, … Y
Y
Y
Y
Y
N
Y
Y
N
N
Y
Y
Y
Y
16/20
Medication administration record: given night sedation … Medication administration record: given night sedation last night?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-fullreport.pdf
January 01, 2020 - Children are also at risk for complications from sedation or
anesthesia, which are often required for … Sedation and Anesthesia-Related Burden and Risk
Some children will require sedation to ensure minimal … Compared with minimal sedation, moderate and deep sedation
carry a greater risk of airway compromise … Anaesthesia or sedation for paediatric MRI: Advantages and disadvantages. … operating room: Report from the Pediatric
Sedation Research Consortium.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-fullreport.pdf
November 01, 2019 - Use of MRI is limited by availability of
scanners and the frequent need for sedation or anesthesia to … Sedation- and Anesthesia-Related Burden and Risk
Some children will require sedation to ensure minimal … Compared with minimal sedation, moderate and deep sedation
carry risk of airway compromise, hypoxia … Anaesthesia or sedation for paediatric MRI: Advantages and disadvantages. … operating room: Report from the Pediatric
Sedation Research Consortium.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0198-fullreport.pdf
November 01, 2019 - Children are also at risk for complications from
sedation or anesthesia, which is often required for … Sedation and Anesthesia-Related Burden and Risk
Some children will require sedation to ensure minimal … Compared with minimal sedation, moderate and deep sedation carry a greater risk
of airway compromise … Anaesthesia or sedation for paediatric MRI: Advantages and disadvantages. … operating room: Report from the Pediatric
Sedation Research Consortium.
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/sustainability/checklist.html
January 01, 2017 - 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/systems/hospital/fallpxtoolkit/fallpxtool3i.docx
January 01, 2012 - Service Class
Comments
3 (High)
Analgesics,* antipsychotics, anticonvulsants, benzodiazepines†
Sedation
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-195-figures-1-3.pdf
June 30, 2015 - Overuse
•Imaging obtained
without likely benefit
to the patient
Complication of
Imaging Overuse
•Of sedation