1.  How we collect data for SATs, SBTs, RASS and SAS  How has data collection affected our work flow  Have we made any improvements in patient care?  Barriers with data collection and implementation of measures Talking Points:

2.  Charts reviews Done by reviewing the patient's EMR  Daily rounding form Done by night shift ICU nursing manager once or twice a week Data Collection: SATs, SBTs, and RASS

3.  Sedation holiday (SAT) performed twice per day (10am&10pm)  Weaning trial (SBT) performed immediately after SAT and patients extubated as needed. Weaning Readiness Assessment Protocol

4. Process Measures: SAT Compliance Rate

5. Process Measures: SBT Compliance Rate

6. Process Measures: RASS Target

7.  Time constraints  Inadequate/inaccurate charting  Discrepancies in charting actual RASS and targeted RASS  Risk of Self - Extubation  Staffing issues  Nurses’ attitudes towards sedation holiday Barriers to Data collection and implementation of measures

8.  Consistent documentation by Nursing/RT staff  Reduced length of stay on the vent as a result of rigorous SAT/SBT /RASS protocols  Reduced re-intubation rates  Decrease length of ICU and hospital stay Success Stories

9. Unplanned Extubations and Re-intubations

10. Average length of Stay on the Vent