• Nursing in critical care · May 2017

    Comparative Study

    Sedation scoring and managing abilities of intensive care nurses post educational intervention.

    • Vimala Ramoo, Khatijah Lim Abdullah, Patrick Sk Tan, Li Ping Wong, Yan Piaw Chua, and Li Yoong Tang.
    • Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
    • Nurs Crit Care. 2017 May 1; 22 (3): 141-149.

    BackgroundInappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients.Aims And ObjectivesThis study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes.DesignA post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention.MethodsA total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention.ResultsMedian scores for overall accurate sedation scoring (9 months: 4·00; 3 months: 2·00, p = 0·0001) and overall sedation management (9 months: 14·0; 3 months: 7·0, p = 0·0001) were significantly higher at 9 months compared to 3 months post-intervention. There were no significant differences in the perceived self-confidence level for rating sedation level. Overall perceived barrier scores were low (M = 27·78, SD = 6·26, possible range = 11·0-55·0). Patient conditions (M = 3·68, SD = 1·13) and nurses' workload (M = 3·54, SD = 0·95) were the greatest barriers to effective sedation assessment and management. Demographic variables did not affect sedation scoring or management abilities.ConclusionsPositive changes in nurses' sedation assessment and management abilities were observed, indicating that adequate hands-on clinical practice following educational interventions can improve nurses' knowledge and skills.Relevance To Clinical PracticeEducational initiatives are necessary to improve ICU practice, particularly in ICUs with inexperienced nurses.© 2015 British Association of Critical Care Nurses.

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