Predictors for daily interruption of sedation therapy by nurses: a prospective, multicenter study

Area of Science:

• Critical Care Medicine
• Nursing Research

Background:

• Daily interruption of sedation (DIS) is a key component of sedation management in intensive care units (ICUs).
• Understanding factors influencing DIS performance is crucial for optimizing patient care and reducing mechanical ventilation duration.

Purpose of the Study:

• To identify nurse- and patient-related factors that predict the performance of daily interruption of sedation (DIS) by nurses in the ICU.
• To explore the influence of various factors on nurses' willingness and ability to conduct DIS.

Main Methods:

• A bedside interview approach was used to assess nurses' willingness to perform DIS.
• Twenty nurse-related and 47 patient-related factors were evaluated for their influence on DIS completion in mechanically ventilated patients receiving continuous infusions.

Main Results:

• Nurses with prior DIS experience and those not targeting deep sedation were more likely to perform DIS.
• Higher sedative doses, increased fraction of inspired oxygen (Fio(2)), and positive end-expiratory pressure (PEEP) were associated with less DIS performance.
• Nurse-related factors like prior DIS experience and sedation education independently predicted DIS performance, while deep sedation targets independently predicted against it.

Conclusions:

• Educational initiatives and institutional protocols should address both nurse- and patient-specific factors to enhance DIS performance.
• Tailoring strategies based on patient characteristics and nurse experience is essential for effective sedation management.