Date of Doctor of Nursing Practice Project Completion

Spring 2026

Faculty Advisor

Dr. Shannon Warren

Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation holidays. To determine patient readiness, a screening tool was created using existing sedation holiday safety criteria. The tool was implemented for six weeks, and made accessible to nurses via QR code. Using the same questions, a post-intervention survey was distributed to assess for changes in confidence. EHR reports were used to compare compliance rates before and during implementation.

Results

Sedation holiday compliance averaged >93% throughout implementation, demonstrating an 8% increase from the baseline. Though nurse-rated confidence was high at baseline, post-intervention Likert ratings showed small improvements, most notably in understanding and applying the protocol to patient care. The tool was noted to be helpful and easy to use.

Implications

The use of a safety screening tool improved nursing confidence and sedation holiday compliance. Incorporating the tool into the EHR may lead to sustained improvements in compliance, and subsequently improve patient outcomes by reducing continuous sedation use in the intensive care unit.

Keywords

Sedation holiday, spontaneous awakening trial, nurse confidence, nurse perceptions, nurse-led protocol, screening tool

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