Experiences of intensive care nurses assessing sedation/agitation in critically ill patients.
BACKGROUND
Patients admitted to the intensive care unit (ICU) will more often than not require sedative and analgesic drugs to enable them to tolerate the invasive procedures and therapies caused as a result of their underlying condition and/or necessary medical interventions.


OBJECTIVE
This article reports a study exploring the perceptions and experiences of intensive care nurses using a sedation/agitation scoring (SAS) tool to assess and manage sedation and agitation amongst critically ill patients. The principle aims and objectives of this study were as follows: to explore nurse's everyday experiences using a sedation scoring tool; to explore and understand nurse's attitudes and beliefs of the various components of assessing and managing sedation among critically ill patients.


METHODS
Using a descriptive qualitative approach, semistructured interviews were carried out with a purposive sample of eight ICU nurses within a district general hospital ICU. The interviews focused on nurses own experiences and perceptions of using a sedation scoring tool in clinical practice. Burnards 14-stage thematic content analysis framework was employed to assist in the data analysis process.


RESULTS
Three key themes emerged that may have implications not only for clinical practice but for further research into the use of the SAS tool. Benefits to patient care as a direct result of using a sedation scoring tool. The concerns of nursing staff. The implications of using such a tool in clinical practice.


CONCLUSIONS
This paper reinforces the potential benefits to patients as a direct result of implementing the SAS scoring tool and clinical guidelines. Furthermore, it highlights the reluctance of a number of staff to adhere to such guidelines and discusses the concerns regarding less experienced nurses administering sedative agents. Attention was also drawn to the educational requirements of nursing and medical staff when using the SAS scoring tool.
Weir
Stephanie
S
Intensive Care Unit, Crosshouse Hospital, Kilmarnock, UK. stephw2001@hotmail.com
O'Neill
Anna
A
D000328:Adult; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000451:nursing*; D003422:Critical Care / Q000458:organization & administration; D016638:Critical Illness / Q000451:nursing; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing*; D004509:Education, Nursing, Continuing; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment / Q000458:organization & administration*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D018579:Patient Selection; D019555:Physician-Nurse Relations; D017410:Practice Guidelines as Topic; D011595:Psychomotor Agitation / Q000209:etiology / Q000451:nursing*; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000009:adverse effects / Q000451:nursing; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires