Nurses' and physicians' sedation practices in Danish ICUs in 2003 A national survey.
OBJECTIVE
The aim of the study was to describe and compare physicians' and nurses' estimated use of sedatives and analgesics in patients requiring mechanical ventilation in Danish Intensive Care Units (ICUs) in 2003.


METHODS
Questionnaires were mailed in January 2003 to all Danish ICUs providing mechanical ventilation (n = 48). One physician and one nurse at each site were included in the study.


RESULTS
Thirty-nine questionnaires were returned by physicians (response rate 81%) and 43 by the nurses (response rate 90%). Physicians and nurses agreed that sedation related decisions are predominately made during rounds and that most decisions are made by physicians and nurses collaboratively. Only 9% of the nurses and 23% of the physicians reported using a written protocol for sedation, while 30% of the nurses and 44% of the physicians reported the use of sedation scoring systems. The study generally supported the hypothesis, that nurses' and physicians' would respond similarly, but there were, however, significant variations, regarding formal sedation practices.


CONCLUSIONS
Sedation decisions are made collaboratively by nurses and physicians, while sedation protocols and scoring systems are still not systematically implemented in Danish ICUs. The most common drugs for sedation of the mechanically ventilated patient are propofol and fentanyl by continuous infusion. It is recommended that the ICUs collaborate on developing evidence-based standards for sedation and that clinical databases are introduced, which may be used to assess the efficacy of such standards.
Egerod
Ingrid
I
The University Hospitals Centre for Nursing and Care Research (UCSF), Rigshospitalet, Department 7331, Copenhagen, Denmark. ie@ucsf.dk
Christensen
Birgitte V
BV
Johansen
Lena
L
D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D003718:Denmark; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D004363:Drug Utilization / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008505:Medical Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D018579:Patient Selection; D019555:Physician-Nurse Relations; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D012121:Respiration, Artificial / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives