• Alan Rozycki, Andrew S Jarrell, Rachel M Kruer, Samantha Young, and Pedro A Mendez-Tellez.
• Alan Rozycki is a clinical pharmacy specialist, cardiothoracic surgical intensive care, Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio.
• Crit Care Nurse. 2017 Dec 1; 37 (6): 24-34.

BackgroundSociety of Critical Care Medicine guidelines recommend the use of pain, agitation, and delirium protocols in the intensive care unit. The feasibility of nurse management of such protocols in the surgical intensive care unit has not been well assessed.ObjectivesTo evaluate the percentage of adherent medication interventions for patients assessed by using a pain, sedation, and delirium protocol.MethodsData on all adult patients admitted to a surgical intensive care unit from January 2013 through September 2013 who were assessed at least once by using a pain, sedation, and delirium protocol were retrospectively reviewed. Protocol adherence was evaluated for interventions implemented after a nursing assessment. Patients were further divided into 2 groups on the basis of adherence, and achievement of pain and sedation goals was evaluated between groups.ResultsData on 41 patients were included. Of the 603 pain assessments, 422 (70.0%) led to an intervention adherent to the protocol. Of the 249 sedation assessments, 192 (77.1%) led to an adherent intervention. Among patients with 75% or greater adherent pain interventions, all interventions met pain goals with significantly less fentanyl than that used in interventions that did not meet goals. Despite 75% or greater adherence with interventions for sedation assessments, only 8.7% of the interventions met sedation goals.ConclusionsA nurse-managed pain, agitation, and delirium protocol can be feasibly implemented in a surgical intensive care unit.© 2017 American Association of Critical-Care Nurses.

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