Factors influencing nurse sedation practices with mechanically ventilated patients: a U.S. national survey

Abstract

Objectives: Mechanically ventilated patients commonly receive sedative medications. There is increasing evidence that sedative medications impact on patient outcomes. Nursing behaviour is a key determinant of sedation administration. The purpose of this study was to determine factors that influence nurse sedation administration to mechanically ventilated patients.

Methods: The Nurse Sedation Practices Scale was mailed to a random sample of 1250 members of the American Association of Critical Care Nurses.

Results: A response rate of 39% was obtained. Respondents were primarily staff nurses (73%) with a bachelor's degree in nursing (59%) from various intensive care unit (ICU) settings. We limited the analysis to adult ICU practitioners (n=423). The majority of nurses (81%) agreed that sedation is necessary for patient comfort. Nurse attitudes towards the efficacy of sedation for mechanically ventilated patients was positively correlated with nurses' report of their sedation practice (r(s)=.28, p<.001) and their intent to administer sedation (r(s)=.58, p<.001). Attitudes did not vary with respect to individual or practice setting characteristics.

Conclusion: Nurses' attitudes impact sedation administration practices. Modifying nurses' attitudes on sedation and the experience of mechanical ventilation may be necessary to change sedation practices with mechanically ventilated patients.