Effects of nurses’ practice of a sedation protocol on sedation and consciousness levels of patients on mechanical ventilation

Mohammad Esmaeili Abdar, Hossein Rafiei, Abbas Abbaszade, Hakimeh Hosseinrezaei, Zahra Esmaeili Abdar, Masoumeh Delaram, Mehdi Ahmadinejad


Background: Providing high-quality care in the intensive care units (ICUs) is a major goal of every medical system. Nurses play a crucial role in achieving this goal. One of the most important responsibilities of nurses is sedation and pain control of patients. The present study tried to assess the effect of nurses’ practice of a sedation protocol on sedation and consciousness levels and the doses of sedatives and analgesics in the ICU patients.

Materials and Methods: This clinical trial was conducted on 132 ICU patients on mechanical ventilation. The patients were randomly allocated to two groups. While the control group received the ICU’s routine care, the intervention group was sedated by ICU nurses based on Jacob’s modified sedation protocol. The subjects’ sedation and consciousness levels were evaluated by the Richmond Agitation Sedation Scale (RASS) and the Glasgow Coma Scale (GCS), respectively. Doses of administered midazolam and morphine were also recorded.

Results: The mean RASS score of the intervention group was closer to the ideal range (−1 to +1), compared to the control group (−0.95 ± 0.3 vs. −1.88 ± 0.4). Consciousness level of the control group was lower than that of the intervention group (8.4 ± 0.4 vs. 8.8 ± 0.4). Finally, higher doses of midazolam and morphine were administered in the control group than in the intervention group.

Conclusion: As nurses are in constant contact with the ICU patients, their practice of a sedation protocol can result in better sedation and pain control in the patients and reduce the administered doses of sedatives and analgesics.

Key words: Consciousness level, nurse, pain, sedation, sedation protocol

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