Table 1 Proposed order set quality elements based on the 2002 sedation guidelines expert-validated quality score

Pain is regularly assessed

1.0 (0)

Sedation is regularly assessed

1.0 (0)

Delirium is regularly assessed

1.7 (0.72)

Pain is regularly documented

1.0 (0)

Sedation is regularly documented

1.0 (0)

Delirium is treated on a symptom-oriented basis

1.9 (0.64)

Validated pain scale is used to assess pain

1.2 (0.56)

Validated sedation assessment scale is used

1.1 (0.26)

Antipsychotic medications are included in the order set for the pharmacologic treatment of delirium

1.7 (0.72)

Self-report of pain is used to assess pain

1.2 (0.56)

Sedation goal or endpoint is established for each patient

1.0 (0)

The QT interval is monitored in patients receiving antipsychotics ^a

1.8 (0.77)

Therapeutic goal of analgesia is established

1.1 (0.35)

The sedative dose is titrated to a defined endpoint

1.0 (0)

The analgesia goal is patient specific

1.0 (0)

Sedation of agitated critically ill patients is started only after providing adequate analgesia

1.4 (0.63)

Analgesic medications are titrated based on the patient's goal and plan

1.0 (0)

Sedation of agitated critically ill patients is started only after treating reversible physiologic causes

1.4 (0.63)

NSAIDs or acetaminophen should be provided as optional adjuncts to opioids in selected patients

2.0 (0.76)

A sedation algorithm or protocol is used to guide the administration of sedation

1.2 (0.41)

Scheduled opioid doses or a continuous infusion are given preferentially over an as-needed regimen

2.7 (1.1)

Daily interruption of sedation is performed in all patients who lack a contraindication

1.1 (0.26)

A patient-controlled analgesia device is preferred to deliver opioids if the patient is able to understand and operate the device

2.1 (0.74)

The daily sedation interruption is explicitly linked to a spontaneous breathing trial

1.4 (0.51)