Conclusion: The nurse implementation of a sedation and analgesia algorithm was associated with a trend towards reduction in duration of MV, ICU and hospital length of stay.
The objective of this study is to show that the nurse implementation of a sedation and analgesia algorithm is beneficial to the patient in terms of sedative drugs reduction and thus overall decrease in duration of mechanical ventilation (MV) and the morbidity and mortality which is associated with it, without altering patient comfort and tolerance of the environment.
It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs.
To identify factors that may facilitate or constrain community nurses' implementation of ACP during patient care.
A lack of inpatient beds has also been shown to increase ED LOS for admitted patients [ 34], which in turn has been associated with a delay in nurse implementation of orders for critically ill patients, both in the ED and upon arrival in the ICU [ 35].
This data review attempted to examine the impact of education campaigns, staff meetings, in-services, physician checklist, nurse checklist, charge nurse checklist implementation, systematic VAP bundle application and systematic protocols for oral care and sedation protocols.
In summary, there is a very limited evidence base for either the design of nursing guideline implementation interventions or for measuring the process and outcome of nursing care.
With funding from the Canadian Health Services Research Foundation, the Canadian Institutes of Health Research and the Canadian Nurses Foundation, we are currently conducting follow-up studies to examine the long-term impact of nursing guideline implementation on clinical and process outcomes.
We found little evidence, however, to support this hypothesis, and, as a result, it is likely that unit-level factors may be more responsible for patient outcomes (for example, volume-outcome relation [ 22, 23]; nurse-to-patient ratio [ 24, 25] or other aspects of nursing organization; implementation of best practices) [ 15, 26].
At a federal level (but with key provincial contacts) the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications, as conceptualized to aid recognition of foreign credentials and smooth the transition of individuals from key occupations including nursing, was implementation December 2010 [ 35].
