Jill 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.
Am J Crit Care. 2019 Jul;28(4):255-263. doi: 10.4037/ajcc2019526.
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.
To explore nurses' self-reported attitudes and practices related to sedation and determine whether they have changed in the past decade.
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.
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 ( = 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.
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.
护士是实施机械通气患者镇静方案的基础。2005 年的一项调查显示，护士对镇静的态度会影响他们的镇静实践。此后，有关疼痛、躁动和谵妄管理的更新指南已经发布。
探讨护士自我报告的与镇静相关的态度和实践，并确定在过去十年中是否发生了变化。
邀请美国危重病护理协会的成员完成护士镇静实践量表，该量表衡量护士自我报告的镇静实践和影响他们的因素。分析了项目和子量表的反应，并确定了受访者特征对项目反应的差异。
受访者（N=177）主要是有学士学位的在职护士（63%）（68%）。护士对镇静在缓解机械通气患者痛苦方面的有效性的态度与他们给予镇静剂的意愿呈正相关（r=0.65）。66%的护士认为镇静是患者舒适的必要条件，34%的护士认为限制患者的回忆是镇静的理想结果。经验更多或持有 CCRN 证书的受访者对镇静减轻痛苦的有效性评价较低。
在过去十年中，护士对接受机械通气的患者进行镇静的态度发生了变化，现在认为所有患者都应该镇静的护士人数减少了。然而，仍有超过一半的护士仍然认为镇静是患者舒适的需要，这突出了在寻求优化机械通气期间的镇静实践时需要考虑护士的态度。
