• Erin N Frazee, Heather A Personett, Seth R Bauer, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Jennifer L Elmer, Sean M Caples, and Craig E Daniels.
• Erin N. Frazee and Heather A. Personett are pharmacists in Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Seth R. Bauer is a medical intensive care unit clinical specialist in the Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio. Amy L. Dzierba is a critical care pharmacist in the Department of Pharmacy, New York Presbyterian Hospital, New York, New York. Joanna L. Stollings is a critical care pharmacist in the Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee. Lindsay P. Ryder is a pharmacist in the Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio. Jennifer L. Elmer is a critical care clinical nurse specialist in the Department of Nursing at the Mayo Clinic. Sean M. Caples and Craig E. Daniels are intensive care physicians in the Division of Pulmonary and Critical Care Medicine, Mayo Clinic. frazee.erin@mayo.edu.
• Am. J. Crit. Care. 2015 Sep 1; 24 (5): 431-9.

BackgroundThe recent increase in use of neuromuscular blocking agents (NMBAs) in patients with acute respiratory distress syndrome is set against a backdrop of concerns about harm associated with use of these high-risk drugs. Bedside nurses play a pivotal role in the safe and effective use of these agents.ObjectiveTo describe critical care nurses' knowledge of the therapeutic properties, adverse effects, and monitoring parameters associated with NMBAs.MethodsA prospective, multicenter survey of medical intensive care unit nurses between July 2012 and May 2013. The web-based survey instrument was designed, pretested, and administered under the direction of a multidisciplinary group of individuals.ResultsResponses from 160 nurses (22% of eligible nurses) were analyzed. Most respondents were able to identify NMBAs correctly as nonanalgesic (93%) and nonanxiolytic (83%). The perceived durations of action of NMBAs varied widely, and few nurses were familiar with patient-specific considerations related to drug elimination. Most (70%) recognized the independent associations between NMBAs and footdrop, muscle breakdown, and corneal ulceration. Pressure ulcers and a history of neuromuscular disease were the characteristics of patients perceived to most heighten the risk of NMBA use.ConclusionsCritical care nurses are knowledgeable about the importance of concurrent analgesia and sedation during use of NMBAs. Routes of elimination, duration of action, and adverse effects were less commonly known and represent areas for focused education and quality improvement surrounding use of NMBAs in the intensive care unit.©2015 American Association of Critical-Care Nurses.

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