Efficacy of Nurse-Led Sedation Protocols in Preventing Ventilator-Associated Pneumonia in Mechanically Ventilated ICU Patients: A Systematic Review
Abstract
Background: Ventilator-associated pneumonia (VAP) remains a significant challenge in intensive care units, especially among mechanically ventilated patients. Sedation protocols, particularly nurse-led interventions, have been suggested to improve patient outcomes by reducing the incidence of VAP. This study evaluated the effectiveness of such protocols on VAP incidence, mechanical ventilation duration and ICU length of stay.
Methods: A comprehensive search of electronic databases, including MEDLINE, EMBASE and Cochrane CENTRAL from inception to 30 August 2024 was conducted following PRISMA guidelines. Nurse-led sedation protocols and their impact on VAP outcomes were selected for meta-analysis. Data extraction included sample size, interventions, control measures and primary outcomes. Statistical analysis was performed using a fixed-effects model to calculate risk differences and odds ratios with heterogeneity assessed using the I² statistic.
Results: The systematic review comprised 15 studies, with 7 studies meeting the criteria for meta-analysis. Nurse-led sedation protocols were associated with a significant reduction in the duration of mechanical ventilation (Risk Difference: -0.21; 95% CI: -0.37 to -0.04, P=0.01). However, analyzing VAP-related mortality, the odds ratio (OR: 0.80; 95% CI: 0.60 to 1.07) indicated no statistically significant difference between intervention and control groups (P=0.14).
Conclusion: Nurse-led sedation protocols show promise in reducing the…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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