ICU Training Helps Reduce Patient Sedation July 23, 2024 Seeing a patient walking around hours after being intubated wasn’t unusual when Kali Dayton, DNP, AGACNP, began her ICU nursing career in Utah. In fact, it was unusual for a patient in the Salt Lake City hospital to remain sedated in the ICU. “When I started in the ICU no one made a big deal out of the fact that almost every patient was awake right after intubation and walking even hours after,” Dayton said. “I didn’t know that was unique.” A few years later when Dayton was a travel nurse, she was surprised to discover intubated patients were sedated in every ICU she visited. “I was really confused,” Dayton said. “I was asking questions like why are these patients sedated? And people thought I was insane, they thought I didn’t have any ICU experience.” Now, through Dayton ICU Consulting, she champions efforts for hospitals throughout the nation to adopt that gold standard of care she learned as a youthful nurse in Utah. Dayton led a three-day course funded by the Good Samaritan Hospital Foundation to instruct staff on best practices at Good Samaritan Regional Medical Center. The Good Samaritan Hospital Foundation’s Isabelle Siracusa Bernier and Paul Emile Bernier Endowment awarded $10,200 for the ICU Mobility and Delirium Project at GSRMC. The Bernier Endowment was established in 2004 to provide funding for the pursuit of continuing education, specialty credentials or certifications. In 2024, the fund supported $40,000 in staff training at GSRMC. “We could not have considered this project without the generous support of the Bernier Endowment,” said Char Gutt, ICU manager. “Their grant provided both the funding for Dayton’s webinars and for her in-person visit.” Before the in-hospital consultation, staff completed Dayton’s series of four webinars discussing ICU mobility, delirium prevention and treatment, and sedation reduction. The in-person consultation was the next step in implementation of awake and walking practices in the GSRMC ICU. “I want them to recognize the power they have to help patients survive and thrive and feel empowered to do so,” said Dayton, who now has consulted with 13 different hospitals over the past two years. Dayton also is the host of a podcast called “Walking Home from the ICU,” which has gained her a national following and more than 170 episodes to her credit. “I am excited about the opportunity to help patients have greater success to survive and walk out the door as they go back to their normal lives,” Dayton said. “Initially it’s hard to make those changes, but once they get to see the success it changes the morale and the team dynamics.” “This training is essential to the multidisciplinary ICU care team because it provides the knowledge and resources to select the best interventions to decrease patients’ time on the ventilator, prevent physical deconditioning, shorten hospital stays and improve patient outcomes,” Gutt said. Dayton’s course included a hands-on element that demonstrated a verticalization bed that can lift a patient into an upright position. Using the bed can help increase lung function and reduce muscle atrophy. “This all highlights the incredible benevolence of clinicians,” Dayton said. “They are willing to do hard work and make huge changes to save lives.” “The 2024 grant provided funding for 12 mobility simulation sessions with staff and some specialties to identify ways to make the early mobility process work at GSRMC,” Gutt said. “Our hope is to take what we learn here and eventually implement the process across all our hospitals.”
