Intensive Care Unit Joint Commission Remediation Plan 2021

Abstract

Background: Nurses in the intensive care unit (ICU) are tasked with caring for patients who are mechanically ventilated and require medications to induce sedation and/or pain relief. Sedation assists to prevent agitation that can cause disruptions to care, promote patient safety, and reduce mortality (Aragón et al., 2019). Using a standardized and validated tool such as Richmond Agitation-Sedation Scale (RASS) for sedation and Critical-Care Pain Observation Tool (CPOT) for pain can assist nurses in ensuring that the patient’s level of sedation and/or pain relief is optimal and safe. Problem: This Doctor of Nursing Practice (DNP) project addressed the lack of accurate nursing sedation and analgesia medication drip assessment, titration, and documentation in the ICU as cited by The Joint Commission in June 2021. Methods: Interventions included a comprehensive education program for new ICU nurses, education for the current staff, an annual in-service, a written policy, order set revisions, and electronic medical record (EMR) modifications. . Results: Accurate titrations vs. titration opportunities were 80.1% in September 2021 as compared to 80.7% in April 2022. Accurate documentation versus documentation opportunities were 70.8% in September 2021 as compared to 96.4% in April 2022. Recommendations: Engaging the multidisciplinary team provided an environment that allowed for widespread interventions and system-wide input to improve patient outcomes. Further studies are needed to determine what interventions could be successfully utilized to improve titration accuracy with sedation/analgesia medications in the ICU setting.