In mechanically ventilated adults patients, are daily sedation breaks compared to a continuous sedation, more efficient in reducing the ventilated days and length of ICU stay?

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ACKNOWLEDGEMENTS

This dissertation is an opportunity for me to extend my regards to my research supervisor, my beloved friends and my family for their untiring support that they furnished throughout my research. I am grateful to them for their belief in me and the guidance that they provided me without which I would have never been able to work on and complete this research. It also signifies my own views and does not closely relate to the university.

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Date: __________________________DECLARATION

I, (Your name), would like to declare that all contents included in this study stand for my individual work without any aid, and this proposal has not been submitted for any examination at academic as well as professional level, previously. It is also represents my very own views and not essentially those that are associated with other university.

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Table of Contents

ACKNOWLEDGEMENTSi

DECLARATIONii

CHAPTER 1: INTRODUCTION1

Purpose of the study1

Background of the study1

Significance of the study2

PICO question3

CHAPTER 2: METHODOLOGY4

Evidence based practice (EBP)5

Qualitative Design5

Justification of using the Qualitative design6

Inclusion and Exclusion Criteria7

Inclusion criteria7

Exclusion criteria8

References9

CHAPTER 1: INTRODUCTION

Purpose of the study

In the mechanically ventilated patients the analgesic and sedatives are used widely to guarantee comfort, So far there are no such documented studies suggesting the sedation effect on the perception of patients regarding discomfort. The aim of this study was, therefore, to investigate and determine whether the use of continuous sedation and daily sedation breaks is associated with prolongation of the duration of mechanical ventilation and reduction in the length of ICU stay.

Background of the study

The critical illness is defined as requiring a treatment in intensive care which is a significant stressful event. The intensive care unit (ICU) environment, the therapeutic procedures, the acute stress reaction, and the life-threatening illness are likely to result in discomfort. The presences of hallucinations, nightmares, sleep disturbances, anxiety, fear, thirst, pain, an endo-tracheal tube (ETT), has been known to cause stressful experiences among the intensive care unit patients (Roberts and Chaboyer, 2004, pp. 173; Granja et al., 2005, pp. 96). To ensure the safety and comfort, analgesic and sedative agents are widely used in the patients who are critically ill (Walder and Tramer, 2004, pp. 333). It is thought that while the patient is mechanically ventilated the intubated patients are treated mostly with the sedatives as it has become a vital component for the treatment (Izurieta and Rabatin, 2002, pp. 2644). Yet the information about the pharmacological sedation impact on the patients who are strictly ill, their perception of discomfort and memory is sparse (Rundshagen et al., 2002, pp. 38). In the current literature there are no studies found who has focused on the relationship between the stressful experiences of mechanically ventilated patients, and sedative use along with the depth of sedation.

From last two decades, a wide interest has been in the patients on the mechanical ventilator and their ICU stay ...