The WAKE UP component promotes opioid and sedation management with the goal of reducing unnecessary sleepiness and sedation, which allows for early mobilization, reduction of delirium, decreased risk of respiratory compromise and shortened length of stay. The interrelated strategy of SCRIPT UP promotes optimizing inpatient medications. Monitoring reversal agents and maintaining a continued emphasis on minimal sedation can assist in the prevention of several harm events: adverse drug events (ADE), airway safety, delirium, failure to rescue, falls, ventilator-associated events (VAE) and venous thromboembolism (VTE).

FHA will focus on WAKE UP April - June 2018.

The acronym is a reminder of the practices an organization needs to have in place to effectively initiate appropriate sedation management:

W - WARN yourself: this is high risk.
A - ASSESS: use tools (STOP-BANG, POSS, RASS, PA-PSA).
K - KNOW: your drugs, your patient.
E - ENGAGE: patients and families to set realistic pain expectations, use of non-sedating analgesics, risks of opioids.
U - UTILIZE: dose limits, layering limits, soft and hard stops.
P - PROTECT: the Patient…our ultimate job.

FHA Resources

• FHA WAKE UP Toolkit & Resource Guide
• FHA WAKE UP Badge cards
• FHA WAKE UP E-mail Banner
• FHA WAKE UP Harm Prevention Flyer
• FHA WAKE UP Posters (Customizable - Add your own logo)
• FHA WAKE UP Posters (Print-ready)
• FHA WAKE UP Social Media Messaging
• FHA SCRIPT UP Harm Prevention Flyer

FHA WAKE UP Newsletters

• MUST DO #1 | Establish Expectations (Apr. 27, 2018)
• MUST DO #2 | Pair POSS & Pain (Jun. 5, 2018)
• MUST DO #3 | Multimodal Pain Management (Jun. 26, 2018)

Additional Resources

Health Resource & Educational Trust (HRET)

• Topic-specific resources such as change packages, checklists, guidelines, case studies, peer-shared resources and more are available on the HRET-HIIN.org Web site:
• Adverse Drug Events (ADE)
• Airway Safety
• Delirium
• Failure to Rescue
• Falls with Injury
• Ventilator-Associated Events (VAE)
• Venous Thromboembolism (VTE)

Other Resource Materials

• Statement on Preventing Harm from Oversedation in Adult Hospitalized Patients (Oregon Patient Safety Commission)
• The Pain Assessment and Management Initiative (PAMI) & The Joint Commission Pain Standards
• The Johns Hopkins Pain Control and Comfort Menu
• Mayo Clinic Non-pharmacological Interventions
• Multimodal Pain Management and the Future of a Personalized Medicine Approach to Pain, an AORN Continuing Education Opportunity
• Assessment of Sedation during Opioid Administration for Pain Management (Journal of PeriAnesthesia Nursing, Vol 24, No 3 (June), 2009.)
• Nurses' Role in Improving the Pain Management Culture (IndustryEdge, A Press Ganey Publication, Aug. 2016.)
• Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists (The Journal of the American Society of Anesthesiologist, Inc., Anesthesiology 4 2002, Vol.96, 1004-1017.)
• Hospital Elder Life Program (HELP) for Prevention of Delirium
• Sedation, Delirium and Mobility in ICU Patients (Institute for Healthcare Improvement)

Education and Training for Health Care Providers

Virtual Events

• Sharing Successes: Implementation of a Mobility Team | Slides (pdf)
• WAKE UP Virtual Event: Managing Pain, Avoiding Oversedation
• WAKE UP Virtual Event: Sedation-Too Much Temptation?
• Failure to Rescue: How to Proactively Identify Patients at Risk
• SCRIPT UP Virtual Event: Optimizing Patient Medications, Minimizing Adverse Events
• Watch Other Past Virtual Trainings

For more information, contact FHA MTC HIIN at hiin@fha.org or 407-841-6230.