A multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation.
BACKGROUND
Nursing-directed sedation protocols have been shown to reduce the duration of mechanical ventilation and shorten the length of intensive care unit (ICU) stay among critically ill adult patients.


METHODS
We designed a self-administered questionnaire to understand nurses' satisfaction with current sedation and analgesia practices as well as drug therapies in the ICU setting and the perceived relevance of sedation protocols to patient care and nursing autonomy. We surveyed nurses from 3 academic medical-surgical ICUs that were not using a sedation protocol or a sedation scale. Responses were based on a 5-point Likert scale and on text responses to open-ended questions.


RESULTS
Of the 88 respondents, only 52.7% were satisfied (score, > or =4) overall with their local ICU's approach to sedation and analgesia. Nurses favored the use of morphine (85.0%), midazolam (71.2%), and fentanyl (59.6%) over that of lorazepam (38.6%) and haloperidol (15.4%). Some nurses (39.3%) were satisfied with the subjective methods used in their ICU to evaluate sedation adequacy. Almost all respondents believed that a nursing-directed sedation protocol combined with a sedation/agitation scoring system would be valuable to patient care (84.3%) as well as professional nursing practice (85.3%) and that a standardized approach by nurses and physicians was important (81.6%).


CONCLUSIONS
In this survey of ICU nurses, we identified a perceived need for improvement in sedation and analgesia practices. Most respondents believed that the use of a nursing-directed sedation protocol in combination with a sedation scoring system would provide greater practice consistency among nurses and physicians and thus improve the care of critically ill patients.
Mehta
Sangeeta
S
University of Toronto, Toronto, Ontario, Canada M5G 1X5.
Meade
Maureen O
MO
Hynes
Patricia
P
Filate
Woganee A
WA
Burry
Lisa
L
Hallett
David
D
McDonald
Ellen
E
Cook
Deborah J
DJ
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D001007:Anxiety / Q000517:prevention & control; D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007362:Intensive Care Units; D009730:Nursing Assessment; D009864:Ontario; D010146:Pain / Q000517:prevention & control; D011595:Psychomotor Agitation / Q000517:prevention & control; D012121:Respiration, Artificial / Q000451:nursing*
D000700:Analgesics; D006993:Hypnotics and Sedatives