Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456 Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway.
Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456 Oslo, Norway; Faculty of Health Studies, VID Specialized University, Oslo, Norway.
Intensive Crit Care Nurs. 2023 Oct;78:103452. doi: 10.1016/j.iccn.2023.103452. Epub 2023 May 11.
To explore critical care nurses' experiences of caring for adult patients experiencing iatrogenic opioid withdrawal in the intensive care unit.
RESEARCH METHODOLOGY/DESIGN: A qualitative study with an explorative and descriptive design was conducted. Data were collected through semi-structured interviews and systematic text condensation was used to analyse the data. The study was reported according to the consolidated criteria for reporting qualitative research checklist.
Ten critical care nurses, working at three different intensive care units in two university hospitals in Norway.
Three categories were identified in the data analysis. "Subtle signs and symptoms of opioid withdrawal", lack of a systematic approach to opioid withdrawal, and the prerequisites for appropriate management of opioid withdrawal. Critical care nurses experienced challenges in identifying opioid withdrawal due to subtle and vague signs and symptoms, especially when not knowing their patient or when difficulties were encountered with patient communication. A systematic approach to opioid withdrawal and increased knowledge, definitive plans for weaning, as well as interdisciplinary unity and collaboration, could improve the management of opioid withdrawal.
Validated assessment tools, systematic strategies, and guidelines are essential for the management of opioid withdrawal in opioid naïve patients in intensive care units. The prerequisites for an appropriate management of opioid withdrawal are an accurate and effective communication among critical care nurses and other healthcare professionals involved in patient care.
There is a need for a validated assessment tool, systematic strategies, and guidelines for the management of opioid withdrawal in opioid naïve patients in intensive care units. Increased emphasis needs to be placed on the process of identifying iatrogenic opioid withdrawal and improving opioid withdrawal management in the education system and clinical practice.
探讨重症监护病房护士照顾经历医源性阿片类药物戒断的成年患者的经验。
研究方法/设计：这是一项定性研究，采用探索性和描述性设计。通过半结构化访谈收集数据，并使用系统文本凝结来分析数据。该研究按照定性研究报告的统一标准清单进行了报告。
10 名重症监护病房护士，在挪威两家大学医院的三个不同的重症监护病房工作。
数据分析中确定了三个类别。“阿片类药物戒断的微妙迹象和症状”、缺乏阿片类药物戒断的系统方法，以及适当管理阿片类药物戒断的先决条件。重症监护病房护士由于微妙和模糊的迹象和症状，在识别阿片类药物戒断方面存在挑战，尤其是当不了解他们的患者时，或者在与患者沟通时遇到困难时。阿片类药物戒断的系统方法、增加知识、明确的戒断计划，以及跨学科的统一和协作，可以改善阿片类药物戒断的管理。
在重症监护病房中，对阿片类药物戒断的管理需要经过验证的评估工具、系统策略和指南。适当管理阿片类药物戒断的前提是重症监护病房护士和参与患者护理的其他医护人员之间进行准确和有效的沟通。
在重症监护病房中，对阿片类药物戒断的管理需要经过验证的评估工具、系统策略和指南。需要在教育系统和临床实践中更加重视识别医源性阿片类药物戒断和改善阿片类药物戒断管理的过程。
