Date of Award

Fall 12-1-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Dr. Sheri Jacobson

Second Advisor

Dr. Marites Sewell


Practice Problem: The intensive care unit poses many challenges for nurses. Nurses are placed in a position to decide on dosing and administration, which could conflict with their scope of practice, and documentation needs to coincide with orders. The accuracy of nursing documentation plays a vital role in measuring the outcomes, and failure to document accurately could result in noncompliance with scope of practice or a medication error.

PICOT: For intensive care nurses (P), how does block charting of vasoactive medications (I) compared to current documentation practices (C) affect the accuracy of nurses' documentation (O) within 4 weeks?

Evidence: Nursing documentation is a vital source of information regarding the patient's care and is used to assess and manage the patient's condition; further, it is the nurse's professional responsibility to outline the essentials of patient care and to implement patient safety and quality. Noncompliance with documentation can affect the organization legally and financially.

Intervention: Education and training in utilizing block charting were provided to the superusers, who then trained the remaining staff. utilizing block charting. Block charting documents the swift titration and modifications of vasoactive medication dosages in critical scenarios, employing a standardized and structured methodology. Block charting also promotes precise and punctual recording of medication administration and modifications.

Outcome: Before the implementation of block charting, documentation accuracy was 68%. After implementing the intervention over three weeks, compliance increased to 73%, which is an overall improvement of 5% and a change percentage improvement of 7.35%.

Conclusion: The project change needs auditing for at least 6 months to ensure compliance. Further staff education and training are warranted to ensure proper and accurate documentation practices. Continuous improvement is a concern and necessitates education and training for new ICU nurses and a focus on this practice with all new ICU hires.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

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