| Learning Objective #1: Understand the importance of monitoring sedation outcomes in the ICU environment | |||
| Learning Objective #2: Discuss and implement an evidence-based treatment plan for bedside sedation practices in the ICU environment |
Research Question: What is the relationship between BIS scores and MAAS in mechanically ventilated patients undergoing standardized sedation protocol?
Research Design / Methods / Statistical Analysis: After IRB approval, thirty adult mechanically ventilated ICU patients undergoing sedation protocol were enrolled in a descriptive, prospective, observational investigation after surrogate consent was obtained. Repeated measures design was used with hourly MAAS scores and 750 blinded BIS values recorded for a continuous 24-hour period. Hourly MAAS scores for this period were obtained from staff nurses' charting.
Study Findings: The sample had a mean age of 62.9 years, 63% were male, and 37 % female, 40% were medicine, and 60% surgical patients. For each MAAS score group, an overall mean BIS was calculated (Table 1). Linear regression determined that there was a strong (r2= 0.93, p <.0001) correlation between BIS and each MAAS group. BIS scores appeared to be more accurate in determining sedation levels.
Conclusions: MAAS and BIS are effective tools for determining level of sedation in mechanically ventilated ICU patients. The correlation between subjective and objective scales varied in medical and surgical patients with BIS appearing to be more accurate.
Implications for Nursing: More accurate sedation monitoring will improve nursing assessment and could lead to decreased morbidity and mortality. An objective scoring system, such as BIS, further benefits the patient by providing one-on-one, twenty-four hour, continuous monitoring of sedation levels. Shorter hospital stays, decreased medication costs, and improved quality of nursing care benefit everyone.