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Nurses' Decision-Making and Confidence With Titration of Vasoactive Medication.
Eugene Waterval1, Tara Hunt2, Daleen Penoyer3
1Eugene Waterval is director for research and education, Nemours Children's Health, Central Florida, Orlando, Florida.
Summary
Critical care nurses use protocols and clinical judgment for vasoactive medication titration. Their decision-making and confidence are shaped by knowledge, patient history, and teamwork, not just experience levels.
Area of Science:
- Nursing Practice
- Critical Care Medicine
- Pharmacology
Background:
- Critical care nurses titrate intravenous vasoactive medications.
- Nurses historically used clinical judgment before 2017 protocol standards.
- Understanding nurses' decision-making in vasoactive medication titration is crucial for patient outcomes.
Purpose of the Study:
- To explore critical care nurses' practices and decision-making when titrating vasoactive medications.
- To understand nurses' perceptions regarding vasoactive medication titration.
Main Methods:
- Prospective, single-site, convergent mixed-methods, descriptive design.
- Quantitative data collected via nurse surveys (Clinical Decision-Making in Nursing Scale, Confidence Scale).
- Qualitative data gathered through semistructured interviews.
Main Results:
- No significant differences in decision-making or confidence scores across demographic groups.
- Four key themes emerged: protocol adherence, knowledge application, patient history consideration, and professional collaboration.
- Survey saturation occurred after 10 interviews.
Conclusions:
- Vasoactive medication titration protocols are valued but have limitations.
- Effective titration relies on a strong knowledge base, experience, and interprofessional collaboration.
- Consistent confidence levels may stem from unit support or pandemic-related experience.
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