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

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.