Other Titles

Interprofessional Plan of Care:​ Reducing Intubation Time With Spontaneous Awakening Trials​ [Title Slide]

Abstract

Prolonged time on mechanical ventilation leads to an increased risk of ventilator-associated complications, prolonged hospital stays, increased hospital costs, and increased mortality (Haribhai & Mahboobi, 2022). The implementation of Spontaneous Awakening Trial (SAT) protocols in the intensive care unit (ICU) led to shorter use of sedation, increased spontaneous breathing trials (SBT), and shortened vent durations (Green & Staffileno, 2021). However, nurses may not perform SATs daily due to concerns for patient comfort, safety, and ventilation asynchrony (Ketcham et al., 2022).

This project aimed to increase SATs performed on intubated patients and decrease time to extubation. The IOWA model framework was used to answer the clinical question: In mechanically ventilated patients on sedation, what is the effect of promoting daily SATs using targeted nursing education and point-of-care reminder prompts on time to extubation? Education was provided to emphasize the significance of SATs and safe SAT eligibility in a medical intensive care unit (MICU) using presentations, badge buddies, and reminder prompts on unit computers. Pre-implementation data showed the median days of intubation being 3.6.

The project was conducted in a 14-bed MICU and implemented over three months, from October of 2023 to January of 2024. The project discovered that increasing education and following up with reminders led to increased SATs, resulting in one less ventilator day. The median days of intubation post-implementation were 2.44.

This project implies that better SAT protocol compliance can lead to shorter durations of intubation for critically ill patients. Research shows that nurses who received education about sedation weaning had patients with significantly shorter ICU length of stay, fewer days on the ventilator, and fewer ventilator-associated complications (Lee et al., 2017).

Notes

References:

Haribhai S, Mahboobi SK. Ventilator Complications. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560535/

Green, S., & Staffileno, B. A. (2021). Favorable Outcomes After Implementing a Nurse-Driven Sedation Protocol. Critical care nurse, 41(6), 29–35. https://doi.org/10.4037/ccn2021625

Ketcham, S. W., Adie, S. K., Brummel, K., Walker, E., Prescott, H. C., & Thomas, M. P. (2022). Implementation of a Nurse-Driven Spontaneous Awakening Trial Protocol in a Cardiac Intensive Care Unit. Critical care nurse, 42(2), 56–61. https://doi.org/10.4037/ccn2022114

Lee, Y. L., Sims, K. D., Butts, C. C., Frotan, M. A., Kahn, S., Brevard, S. B., & Simmons, J. D. (2017). The Combination of SAT and SBT Protocols May Help Reduce the Incidence of Ventilator-Associated Pneumonia in the Burn Intensive Care Unit. Journal of burn care & research : official publication of the American Burn Association, 38(2), e574–e579. https://doi.org/10.1097/BCR.0000000000000451

Description

The study aimed to increase Spontaneous Awakening Trial (SAT) protocols in ICUs to reduce ventilator-associated complications. The IOWA model framework was used to assess the effect of promoting daily SATs using nursing education and reminder prompts. The project found that increased education and reminders led to increased SATs, resulting in one less ventilator day. This suggests that better SAT protocol compliance can lead to shorter intubation durations for critically ill patients.

Author Details

Melany Cepeda Reinoso, BSN, RN and Erica Browne, BSN, RN, CCRN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Acute Care, Interprofessional Initiatives, Instrument and Tool Development, Clinical Practice, Promoting Clinical Outcomes, Intubation, Mechanical Ventilation

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-26

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Reducing Intubation Time with Spontaneous Awakening Trials

Indianapolis, Indiana, USA

Prolonged time on mechanical ventilation leads to an increased risk of ventilator-associated complications, prolonged hospital stays, increased hospital costs, and increased mortality (Haribhai & Mahboobi, 2022). The implementation of Spontaneous Awakening Trial (SAT) protocols in the intensive care unit (ICU) led to shorter use of sedation, increased spontaneous breathing trials (SBT), and shortened vent durations (Green & Staffileno, 2021). However, nurses may not perform SATs daily due to concerns for patient comfort, safety, and ventilation asynchrony (Ketcham et al., 2022).

This project aimed to increase SATs performed on intubated patients and decrease time to extubation. The IOWA model framework was used to answer the clinical question: In mechanically ventilated patients on sedation, what is the effect of promoting daily SATs using targeted nursing education and point-of-care reminder prompts on time to extubation? Education was provided to emphasize the significance of SATs and safe SAT eligibility in a medical intensive care unit (MICU) using presentations, badge buddies, and reminder prompts on unit computers. Pre-implementation data showed the median days of intubation being 3.6.

The project was conducted in a 14-bed MICU and implemented over three months, from October of 2023 to January of 2024. The project discovered that increasing education and following up with reminders led to increased SATs, resulting in one less ventilator day. The median days of intubation post-implementation were 2.44.

This project implies that better SAT protocol compliance can lead to shorter durations of intubation for critically ill patients. Research shows that nurses who received education about sedation weaning had patients with significantly shorter ICU length of stay, fewer days on the ventilator, and fewer ventilator-associated complications (Lee et al., 2017).