Reducing Length of Stay in Intensive Care

Conwy and Denbighshire NHS Trust
Bodelwyddan, Wales, United Kingdom



Sue O’Keeffe, RGN, BSc (Hons) Practice Development Sister
Mark Williams-Jones, RGN, BSc (Hons) Clinical Leader
Linda Leech, RGN, DipN, Staff Nurse
Dr. Brian Tehan, Divisional Clinical Director



Decrease the number of adverse events by 50 percent within two years.




  • Implemented the Ventilator Bundle
  • Conducted training and education sessions for staff
  • Developed guidelines for each element of the bundle
  • Tested ‘daily sedation break’ on one patient
  • Developed ventilator care bundle checklist (PDSA methodology)
  • Tested ‘daily sedation break’ on three patients
  • Tested ‘daily sedation break’ on five patients
  • Tested ‘whole’ bundle on one patient
  • Tested ‘whole’ bundle on three patients
  • Tested ‘whole’ bundle on five patients
  • Tested ‘whole’ bundle on all patients
  • Audited daily compliance of whole bundle
  • Continued training sessions for multidisciplinary team
  • Developed ‘daily goal sheets’ to include compliance with Ventilator Bundle







Summary of Results / Lessons Learned / Next Steps

The implementation of the Ventilator Bundle has resulted in a change to many processes of care on the ICU. Multidisciplinary team working has improved with medical staff willing to allow increased autonomy for the nursing staff. This cultural shift has enabled other bundles and guidelines to be implemented without barriers.

  • Rapid cycle, small steps of change are a revolution to our change management.
  • Education, education, and education. If the staff understand why you are asking them to do something they are more likely to comply.

Contact Information

Sue O’Keeffe, Acting Head of Modernisation
Conwy and Denbighshire NHS Trust

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