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The use of formal sedation holds was recorded on a daily basis.
Despite the mostly good evidence and a comparably easy and cheap means of improving care, not all hospitals have implemented a formal sedation guideline.
In Finland, Tallgren and colleagues [ 3] reported that reinforcing a sedation guideline increased the percentage of expected Ramsay scale recordings made, but only to 71% of expected recordings that were actually made, indicating that formal sedation assessments were still not carried out as regularly as they should have been.
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39 The formal acknowledgement of a sedation weaning phase with a dedicated assessment tool and tapering regime was new practice for the study units.
In contrast to 'patient-targeted sedation protocols', no formal algorithm has been established for drug escalation.
The protocol includes a formal suggestion to practice daily sedation interruption, which was driven by the assistant nurse.
However, the limitation in our study is that our protocol did not have a formal intra-procedural assessment by sedation team.
Dexmedetomidine, a sedative with high α2-adrenoreceptor affinity and agonist action in the locus ceruleus, is the first sedative drug introduced for long-term ICU sedation to undergo formal evaluation for safety and efficacy according to modern drug development standards.
Although there was no formal assessment of the level of sedation of our infants done, bedside nurses reported not being able to discriminate between groups 5 minutes after injection of the study drug.
Although almost all VAP-bundle elements already were used in our ICU, the formal implementation of the Belgian VAP-bundle in 2012 caused an important additional decline in VAP-rate, emphasizing the importance of sedation control and compliance measurement.
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