Investigating nurses' perceptions of their role in managing sedation in intensive care: an exploratory study

Most patients who are admitted to intensive care in need of ventilator support may also require sedation. It is a part of the nurses' role to manage sedation therapy according to patients' needs, avoiding complications of over and under sedation. The purpose of the study was to explore nurses' perceptions of their role in sedation management. A convenience sample of 107 registered nurses in the intensive care unit of a large teaching hospital was accessed and a response rate of 86% (n=92) obtained. Results showed that the nurse has a major role in sedation management in the critically ill patient. Sedation scoring is used in the assessment of the patient's sedation level and sedation is then titrated by the nurse in collaboration with medical staff to an agreed target level. However, the impact of this role depends on the experience and confidence of the nurse as knowledge and skills are required in order to provide effective sedation for patients. Recommendations from this study are to incorporate a team approach within a locally devised sedation protocol. This should be supported by an education programme aiming to improve decision-making about sedation management at the bedside.