Sedation Vacation: Worth The Trip
Michael D. Hogue RN, CCRN
Staci Mamula BSN, RN, CCRN

$7.95 		Nursing2013 Critical Care
January 2013 
Volume 8  Number 1
Pages 35 - 37
 
  PDF Version Available!

ABSTRACT
Daily sedation interruption (DSI, also called a sedation vacation) can be beneficial for mechanically ventilated patients. This article focuses on what nurses need to know about DSI so that evidence-based guidelines are followed when sedatives and analgesics are stopped temporarily.1Our facility's surgical ICU launched a quality improvement project (see About QSEN) to enhance nurse education about DSI in mechanically ventilated patients. The need for education was identified by the unit manager and medical record audits showing that nurses were documenting DSI on only 30% of the medical records reviewed.The current science supporting DSI may be confusing, so keeping nurses up-to-date on continuous sedation in mechanically ventilated patients is a priority. Mechanically ventilated patients often experience pain from endotracheal suctioning, mechanical ventilation, surgical incisions, indwelling catheters, and repositioning in bed.2 The discomfort from these factors results in patients requiring I.V. continuous sedation (which includes analgesia). DSI is needed so that you can assess the patient's neurologic status and determine the necessity for continuation of sedation.Evidence-based practice recommends interrupting sedation at least daily in mechanically ventilated patients to evaluate patient need for remaining on I.V. continuous sedation.1,2 Benefits of DSI include the ability to accurately titrate sedation, which reduces time on mechanical ventilation, length of ICU stay, risk of ventilator-associated pneumonia, and need for neurologic diagnostic tests related to oversedation.1 Patients receiving DSI reported that they're better-able to cope with their illness and experienced less posttraumatic stress disorder symptoms associated with the painful and frightening experience of being intubated and mechanically ventilated.1At our facility, 25 nurses participated in a collegial interview to assess their knowledge of DSI, current practice, and obstacles to performing

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