Clinician perspectives on protocols designed to minimize sedation
Copyright © 2014 Elsevier Inc. All rights reserved..
PURPOSE: Within a multicenter randomized trial comparing protocolized sedation with protocolized sedation plus daily interruption (DI), we sought perspectives of intensive care unit (ICU) clinicians regarding each strategy.
METHODS: At 5 ICUs, we administered a questionnaire daily to nurses and physicians, asking whether they liked using the assigned strategy, reasons for their responses, and concerns regarding DI.
RESULTS: A total of 301 questionnaires were completed, for 31 patients (15 protocol only and 16 DI); 117 (59 physicians and 58 nurses) were the first questionnaire completed by that health care provider for that patient and were included in analyses. Most respondents liked using the assigned strategy (81% protocol only and 81% DI); more physicians than nurses liked DI (100% vs 61%; P < .001). Most common reasons for liking the assigned sedation strategy were better neurologic assessment (70% DI), ease of use (58% protocol only), and improved patient outcomes (51% protocol only and 44% DI). Only 19% of clinicians disliked the assigned sedation strategy (equal numbers for protocol only and DI). Respondents' concerns during DI were respiratory compromise (61%), pain (48%), agitation (45%), and device removal (26%). More questionnaires from nurses than physicians expressed concerns about DI.
CONCLUSIONS: Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Journal of critical care - 30(2015), 2 vom: 03. Apr., Seite 348-52 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rose, Louise [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesia |
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| Anmerkungen: |
Date Completed 30.09.2015 Date Revised 08.04.2022 published: Print-Electronic ClinicalTrials.gov: NCT00675363 Citation Status MEDLINE |
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| doi: |
10.1016/j.jcrc.2014.10.021 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM244203385 |
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| 245 | 1 | 0 | |a Clinician perspectives on protocols designed to minimize sedation |
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| 500 | |a Date Revised 08.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00675363 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Within a multicenter randomized trial comparing protocolized sedation with protocolized sedation plus daily interruption (DI), we sought perspectives of intensive care unit (ICU) clinicians regarding each strategy | ||
| 520 | |a METHODS: At 5 ICUs, we administered a questionnaire daily to nurses and physicians, asking whether they liked using the assigned strategy, reasons for their responses, and concerns regarding DI | ||
| 520 | |a RESULTS: A total of 301 questionnaires were completed, for 31 patients (15 protocol only and 16 DI); 117 (59 physicians and 58 nurses) were the first questionnaire completed by that health care provider for that patient and were included in analyses. Most respondents liked using the assigned strategy (81% protocol only and 81% DI); more physicians than nurses liked DI (100% vs 61%; P < .001). Most common reasons for liking the assigned sedation strategy were better neurologic assessment (70% DI), ease of use (58% protocol only), and improved patient outcomes (51% protocol only and 44% DI). Only 19% of clinicians disliked the assigned sedation strategy (equal numbers for protocol only and DI). Respondents' concerns during DI were respiratory compromise (61%), pain (48%), agitation (45%), and device removal (26%). More questionnaires from nurses than physicians expressed concerns about DI | ||
| 520 | |a CONCLUSIONS: Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Analgesia | |
| 650 | 4 | |a Attitudes of health personnel | |
| 650 | 4 | |a Daily interruption | |
| 650 | 4 | |a Intensive care unit | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Sedation protocol | |
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| 700 | 1 | |a Cook, Deborah |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Steinberg, Marilyn |e verfasserin |4 aut | |
| 700 | 1 | |a Devlin, John W |e verfasserin |4 aut | |
| 700 | 1 | |a Ashley, Betty Jean |e verfasserin |4 aut | |
| 700 | 1 | |a Dodek, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Orla |e verfasserin |4 aut | |
| 700 | 1 | |a Poretta, Kerri |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yoon |e verfasserin |4 aut | |
| 700 | 1 | |a Burns, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Harvey, Johanne |e verfasserin |4 aut | |
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| 700 | 1 | |a Fergusson, Dean |e verfasserin |4 aut | |
| 700 | 1 | |a Meade, Maureen |e verfasserin |4 aut | |
| 700 | 1 | |a Kraguljac, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Burry, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Mehta, Sangeeta |e verfasserin |4 aut | |
| 700 | 0 | |a SLEAP Investigators |e verfasserin |4 aut | |
| 700 | 0 | |a Canadian Critical Care Trials Group |e verfasserin |4 aut | |
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