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Nurses' Attitudes and Practices Related to Sedation: A National Survey
Jill L Guttormson1, Linda Chlan2, Mary Fran Tracy2
1Jill L. Guttormson is an associate professor, Marquette University College of Nursing, Milwaukee, Wisconsin. Linda Chlan is associate dean for nursing research and a professor of nursing, Department of Nursing, and Jay Mandrekar is a professor of biostatistics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. Mary Fran Tracy is an associate professor, University of Minnesota School of Nursing, and nurse scientist, University of Minnesota Medical Center, Minneapolis, Minnesota. Breanna Hetland is an assistant professor, University of Nebraska Medical Center College of Nursing, Omaha, Nebraska. jill.guttormson@marquette.edu.
Background:
Nurses are fundamental to the implementation of sedation protocols for patients receiving mechanical ventilation. A 2005 survey showed that nurses' attitudes toward sedation affected their sedation practices. Since then, updated guidelines on managing pain, agitation, and delirium have been published.
Objective:
To explore nurses' self-reported attitudes and practices related to sedation and determine whether they have changed in the past decade.
Methods:
Members of the American Association of Critical-Care Nurses were invited to complete the Nurse Sedation Practices Scale, which measures nurses' self-reported sedation practices and factors that affect them. Item and subscale responses were analyzed, and differences in item responses by respondent characteristics were determined.
Results:
Respondents (N = 177) were mostly staff nurses (68%) with a bachelor's degree in nursing (63%). Nurses' attitudes toward the effectiveness of sedation in relieving patients' distress during mechanical ventilation correlated positively with their intention to administer sedatives (r s = 0.65). Sixty-six percent of nurses agreed that sedation was necessary for patients' comfort, and 34% agreed that limiting patients' recall was a desired outcome of sedation. Respondents with more experience or CCRN certification had a less positive evaluation of the effectiveness of sedation in minimizing distress.
Conclusions:
Nurses' attitudes toward sedating patients receiving mechanical ventilation have shifted in the past decade, with fewer nurses now believing that all patients should be sedated. However, more than half of nurses still agree that sedation is needed for patients' comfort, highlighting the need to consider nurses' attitudes when seeking to optimize sedation practices during mechanical ventilation.