Date

Summer 2023

Document Type

Scholarly Project

Department

College of Nursing

First Advisor

Margaret Selph

Abstract

Problem Statement: There has been an increase in benzodiazepine use and delirium occurrences in the surgical-trauma intensive care unit (STICU). Purpose: This Doctor of Nursing (DNP) project aimed to explore the current practice of benzodiazepine and sedative use for adult patients admitted to the STICU who developed alcohol withdrawal syndrome (AWS) or delirium. Method: A retrospective chart review with descriptive analysis was completed for all adult patients admitted to the STICU at a regional community level 1 adult and level 2 pediatric trauma center, diagnosed with AWS or delirium, and treated with benzodiazepines during their intensive care unit (ICU) stay. Inclusion Criteria: All patients 18 years of age and older admitted to the STICU from January 2021 to December 2022 who developed AWS or delirium and were treated with benzodiazepines for agitation were included in the retrospective chart review. All STICU nurses, except for those nurses who floated from other ICU units, were invited to complete a 23- item Web-based nursing survey for managing pain, agitation, and delirium (PAD) using clinical decision support systems (CDSS). Analysis: Chi-square statistical tests were used to analyze categorical data and continuous variables. The Pearson Correlation coefficient was used to perform statistical tests. P-values Results: The most common indication for benzodiazepine use in the STICU was CIWA-AR. Nurses were the least comfortable managing agitation and delirium using a tool that relies on subjective data in ventilated patients compared to pain a significant very weak negative correlation present with intervention and satisfaction. Conclusion: Management of PAD and treatment for AWS and delirium do not consistently align with recommended guidelines and policies in the STICU.

Rights

© 2023, Ronelle Guinyard Goodwin

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