Factors influencing nurses' use of sedation interruptions in a critical care unit: a descriptive qualitative study.

Autor:	Graham ND; Faculty of Environmental and Health Sciences, Canadore College, North Bay, ON, Canada., Graham ID; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Vanderspank-Wright B; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada., Nadalin Penno L; Faculty of Environmental and Health Sciences, Canadore College, North Bay, ON, Canada., Fergusson DA; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.; Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Squires JE; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	JBI evidence implementation [JBI Evid Implement] 2024 Aug 01; Vol. 22 (3), pp. 316-329. Date of Electronic Publication: 2024 Aug 01.
DOI:	10.1097/XEB.0000000000000415
Abstrakt:	Introduction and Aims: This study examined critical care nurses', physicians', and allied health professionals' perceptions of factors that support, inhibit, or limit the use of sedation interruption (SI) to improve the use of this integral component of care for mechanically ventilated patients. Method: We conducted a theory-based, descriptive qualitative study using semi-structured interviews with critical care registered nurses, respiratory therapists, a pharmacist, and a physician in a hospital in Ontario, Canada. The interview guide and analysis were informed by the Theoretical Domains Framework and transcripts were analyzed using content analysis. Results: We identified 9 facilitators and 20 barriers to SI use by nurses. Facilitators included the innovation (importance of protocols) and potential adopters (comfort with the skill). The barriers were the potential adopters' (nurses) knowledge gaps regarding the performance and goal of SI and the practice environment (lack of time, availability of extra staff, and lack of multidisciplinary rounds). Conclusion: This study identified facilitators and barriers to SI for mechanically ventilated patients. Implementation efforts must address barriers associated with nurses, the environment, and contextual factors. A team-based approach is essential, as the absence of interprofessional rounds is a significant barrier to the appropriate use or non-use of SI. Future research can focus on the indications, contraindications, and goals of SI, emphasizing a shared appreciation for these factors across disciplines. Nursing capacity to manage a patient waking up from sedation is necessary for point-of-care adherence; future research should focus on the best ways to do so. Implementation study designs should use theory and evidence-based determinants of SI to bridge the evidence-to-practice gap. Spanish Abstract: http://links.lww.com/IJEBH/A178. Competing Interests: The authors declare no conflicts of interest (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the University of Adelaide, JBI.)
Databáze:	MEDLINE
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