"Sedation is tricky" : A qualitative content analysis of nurses' perceptions of sedation administration in mechanically ventilated intensive care unit patients

Authors

Breanna Hetland, University of Nebraska Medical Center
Jill L. Guttormson, Marquette UniversityFollow
Mary Fran Tracy, University of Minnesota - Twin Cities
Linda L. Chlan, Mayo Clinic College of MedicineFollow

Document Type

Article

Language

eng

Publication Date

5-2018

Publisher

Elsevier

Source Publication

Australian Critical Care

Source ISSN

1036-7314

Abstract

Introduction

Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients.

Methods

This is a qualitative content analysis of secondary text data captured through a national electronic survey of members of the American Association of Critical-Care Nurses. A subsample (n = 67) of nurses responded to a single, open-ended item at the end of a survey that evaluated nurses' perceptions of current sedation administration practices.

Findings

Multiple factors guided sedation administration practices, including individual patient needs, nurses' synthesis of clinical evidence, application of best practices, and various personal and professional practice perspectives. Our results also indicated nurses desire additional resources to improve their sedation administration practices including more training, better communication tools, and adequate staffing.

Conclusions

Critical care nurses endorse recommendations to minimise sedation administration when possible, but a variety of factors, including personal perspectives, impact sedation administration in the intensive care unit and need to be considered. Critical care nurses continue to encounter numerous challenges when assessing and managing sedation of mechanically ventilated patients.

Comments

Accepted version. Australian Critical Care, Vol. 31, No. 3 (May 2018): 153-158. DOI. © 2018 Elsevier B.V. Used with permission.

Recommended Citation

Hetland, Breanna; Guttormson, Jill L.; Tracy, Mary Fran; and Chlan, Linda L., ""Sedation is tricky" : A qualitative content analysis of nurses' perceptions of sedation administration in mechanically ventilated intensive care unit patients" (2018). College of Nursing Faculty Research and Publications. 553.
https://epublications.marquette.edu/nursing_fac/553