1. Current practices and barriers impairing physicians' and nurses' adherence to analgo-sedation recommendations in the intensive care unit--a national survey
- Author
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Pierre-François Laterre, Dominique Wouters, Marc M. Perreault, Anne Spinewine, Barbara Sneyers, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service de soins intensifs, and UCL - (MGD) Département de pharmacie
- Subjects
Male ,medicine.medical_specialty ,Attitude of Health Personnel ,Sedation ,medicine.medical_treatment ,MEDLINE ,Psychological intervention ,Nurses ,Pain ,Critical Care and Intensive Care Medicine ,law.invention ,Belgium ,law ,Physicians ,medicine ,Humans ,Hypnotics and Sedatives ,Anesthesia ,Intensive care medicine ,Patient comfort ,Mechanical ventilation ,Response rate (survey) ,business.industry ,Data Collection ,Research ,Intensive care unit ,Respiration, Artificial ,Intensive Care Units ,Emergency medicine ,Practice Guidelines as Topic ,Cost control ,Female ,Guideline Adherence ,medicine.symptom ,Analgesia ,business - Abstract
Introduction Appropriate management of analgo-sedation in the intensive care unit (ICU) is associated with improved patient outcomes. Our objectives were: a) to describe utilization of analgo-sedation regimens and strategies (assessment using scales, protocolized analgo-sedation and daily sedation interruption (DSI)) and b) to describe and compare perceptions challenging utilization of these strategies, amongst physicians and nurses. Methods In the 101 adult ICUs in Belgium, we surveyed all physicians and a sample of seven nurses per ICU. A multidisciplinary team designed a survey tool based on a previous qualitative study and a literature review. The latter was available in paper (for nurses essentially) and web based (for physicians). Topics addressed included: practices, perceptions regarding recommended strategies and demographics. Pre-testing involved respondents’ debriefings and test re-test reliability. Four reminders were sent. Results Response rate was 60% (898/1,491 participants) representing 94% (95/101) of all hospitals. Protocols were available to 31% of respondents. Validated scales to monitor pain in patients unable to self-report and to monitor sedation were available to 11% and 75% of respondents, respectively. Frequency of use of sedation scales varied (never to hourly). More physicians than nurses agreed with statements reporting benefits of sedation scales, including: increased autonomy for nurses (82% versus 68%, P
- Published
- 2014