Nurse Maria Costales has been a staff nurse in a 22-bed critical care unit within a large health care organization for over 10 years. She returned to school for a master's degree in nursing last year and is combining a needed work change with her graduate project. Maria gathered the evidence about sedation and intubation and decided that an evidence-based nurse-directed sedation protocol needed to be developed and implemented at her institu-tion. She plans to enlist the support of the ventilator-associated pneumonia (VA]) committee, which includes members of the interdisciplinary team and frontline health care workers. Maria wants to initiate policies and procedures, includ-ing order sets based on clinical guidelines and existing sedation protocol used by other hospitals for benchmark-ins. She also anticipates that there are a variety of stake-holders who need to be involved, including intensivists,
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clinical nurse specialists (CNS), managers of crib care and pulmonary departments, and directors of In-tensivists, critical care, and pharmacy. In addition, she is considering how to optimize support for her policy. Critical care nurses as well as the intensivists will be educated on this innovation, which will be piloted on a 22-bed critical care unit. 1. What are some of the issues that Maria must plan for? 2. What theory or model might be useful? 3. Who should be involved in the committee to plan this change? 4. What might Maria's first step be in planning for thi1 innovation? 5. How might she or the committee prevent or decrease resistance of other staff—nurses, doctors, and other health care professionals involved?
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