Date of Doctor of Nursing Practice Project Completion
Summer 2026
Faculty Advisor
Dr. Robert Coghlan
Abstract
Abstract
Purpose:
This quality improvement (QI) project evaluated whether provider education and standardized documentation improved adherence to evidence-based physiologic monitoring during behavioral emergency sedation in a prehospital EMS setting.
Background:
Behavioral emergencies are common and often require rapid chemical sedation, with risks of hypoxia, hypercapnia, and cardiovascular instability. At baseline, inconsistent adherence to recommended monitoring and documentation of end-tidal carbon dioxide (EtCO₂) and pulse oximetry (SpO₂) presented an opportunity to improve patient safety.
Methodology:
This QI project educated current adult behavioral emergency protocol in a prehospital EMS setting, re-emphasizing standardized documentation and evidence-based monitoring practices. Utilizing Plan-Do-Study-Act (PDSA) through pre- and post-intervention chart audits and feedback channels, data was compared through simple counts. Post-intervention data presented a smaller sample and fewer-than-expected behavioral sedation encounters, with one week of data missing.
Results:
EtCO₂ monitoring compliance improved 95% to 100%. Documented hypoxic events decreased seven to one, and missing mean arterial pressure (MAP) documentation decreased 14 to three occurrences. Increased abnormal EtCO₂ values likely reflected improved monitoring rather than worsening patient physiology. Although statistically significant physiologic improvements were not demonstrated, process measures indicated greater adherence to evidence-based monitoring practices.
Implications:
Adherence improved with recommended physiologic monitoring through provider education and standardized documentation within an EMS setting. Sustained practice change and enhanced patient safety may continue through educational training, standardized monitoring, and audit-and-feedback processes promoting patient safety. Future implementation across multiple EMS agencies with longer follow-up recommended.
Keywords
quality improvement, emergency medical services, behavioral emergency sedation, capnography, patient safety
Recommended Citation
Jared Aucoin, "Improving Physiologic Monitoring Adherence During Behavioral Emergencty Sedation in a Prehospital Ems System" (2026). Doctor of Nursing Practice Final Project Abstract. 232.
https://digitalcommons.library.tmc.edu/dnp_abstract/232