Nurse education on sedation management in ECMO: A small-group training approach

Abstract

Sedation during Extracorporeal Membrane Oxygenation (ECMO) is challenging due to altered pharmacokinetics. At Manchester University NHS Foundation Trust, Wythenshawe Hospital, the Richmond Agitation-Sedation Scale is the standard tool for sedation monitoring; however, it lacks precision in assessing deep sedation. Bispectral Index (BIS) monitoring offers an objective assessment but remains underused, partly because of limited nursing training. This article presents the implementation of small-group teaching sessions (SGTS) on ECMO sedation and BIS monitoring, integrated into existing ECMO refresher training. The sessions included interactive presentations, followed by anonymous feedback collection to evaluate perceptions of the clarity, relevance, appropriateness and usefulness of the SGTS. Sixty-one staff members attended, and 44 provided feedback. All respondents indicated that their learning needs were met, and 93% reported confidence in using BIS independently. The training was highly rated for clarity, relevance and practical value. Overall, our SGTS approach improved nurses’ understanding and confidence in BIS monitoring and ECMO sedation, supporting broader clinical adoption and highlighting the value of continued professional education.