Clinician perspectives on protocols designed to minimize sedation

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. 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. 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. Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy..

Medienart:

Artikel

Erscheinungsjahr:

2015

Erschienen:

2015

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Journal of critical care - 30(2015), 2, Seite 348-352

Sprache:

Englisch

Beteiligte Personen:

Rose, Louise [VerfasserIn]
Fitzgerald, Emma [Sonstige Person]
Cook, Deborah [Sonstige Person]
Kim, Scott [Sonstige Person]
Steinberg, Marilyn [Sonstige Person]
Devlin, John W [Sonstige Person]
Ashley, Betty Jean [Sonstige Person]
Dodek, Peter [Sonstige Person]
Smith, Orla [Sonstige Person]
Poretta, Kerri [Sonstige Person]
Lee, Yoon [Sonstige Person]
Burns, Karen [Sonstige Person]
Harvey, Johanne [Sonstige Person]
Skrobik, Yoanna [Sonstige Person]
Fergusson, Dean [Sonstige Person]
Meade, Maureen [Sonstige Person]
Kraguljac, Alan [Sonstige Person]
Burry, Lisa [Sonstige Person]
Mehta, Sangeeta [Sonstige Person]

Links:

Volltext
www.ncbi.nlm.nih.gov
search.proquest.com

BKL:

44.00

Themen:

Analgesia
Anesthesia
Attitudes of health personnel
Conscious Sedation - methods
Daily interruption
Hospitals
Intensive care unit
Mechanical ventilation
Medical research
Nurses
Nursing care
Physicians
Psychomotor Agitation - prevention & control
Questionnaires
Respiration, Artificial - methods
Sedation protocol
Studies
Ventilation
Workloads

doi:

10.1016/j.jcrc.2014.10.021

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC1958499854