Impact of a Nurse-Led Sedation Protocol on Selected Clinical Outcomes in Traumatic Brain Injury Patients in Intensive Care Units

Abstract

Traumatic brain injury (TBI) is a major global cause of disability and death. Achieving appropriate sedation is vital to ensure both reliable neurological evaluation and patient comfort. This study aimed to evaluate the impact of nurse-led sedation protocol on selected clinical outcomes in TBI patients. A quasi-experimental design was used. A sample of 80 patients from intensive care units (ICUs) in Northwest Syria was enrolled between February and July 2025. The control group received routine care, while the intervention group followed a nursing sedation protocol. Baseline characteristics were comparable between groups. Patients in intervention group spent more time within optimal sedation range and experienced fewer episodes of over- or under-sedation. The mean ICU stay and mechanical ventilation duration were slightly lower in intervention group but differences were not statistically significant. Self-extubation (10% vs. 27.5%, p = 0.045) and reintubation (15% vs. 37.5%, p = 0.022) were significantly reduced in intervention group. Mortality did not differ significantly. In conclusion, Nursing sedation protocol improved sedation quality, lowered airway-related complications in TBI patients. This study recommends integrating nurse-led sedation protocol into ICU practice.