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Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a qualitative study

Conway, Aaron, Rolley, John, Page, Karen and Fulbrook, Paul 2014, Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a qualitative study, Journal of clinical nursing, vol. 23, no. 3-4, pp. 374-384, doi: 10.1111/jocn.12147.

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Title Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a qualitative study
Author(s) Conway, Aaron
Rolley, John
Page, Karen
Fulbrook, Paul
Journal name Journal of clinical nursing
Volume number 23
Issue number 3-4
Start page 374
End page 384
Total pages 11
Publisher Blackwell Publishing
Place of publication Oxford, England
Publication date 2014
ISSN 0962-1067
Keyword(s) cardiac catheterisation
cardiovascular
comfort
interviews
qualitative study
sedation
Summary Aims and objectives
To explore issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory from the perspectives of senior nurses.

Background
Nurses play an important part in managing sedation because the prescription is usually given verbally directly from the cardiologist who is performing the procedure and typically, an anaesthetist is not present.

Design
A qualitative exploratory design was employed.

Methods
Semi-structured interviews with 23 nurses from 16 cardiac catheterisation laboratories across four states in Australia and also New Zealand were conducted. Data analysis followed the guide developed by Braun and Clark to identify the main themes.

Results
Major themes emerged from analysis regarding the lack of access to anaesthetists, the limitations of sedative medications, the barriers to effective patient monitoring and the impact that the increasing complexity of procedures has on patients' sedation requirements.

Conclusions
The most critical issue identified in this study is that current guidelines, which are meant to apply regardless of the clinical setting, are not practical for the cardiac catheterisation laboratory due to a lack of access to anaesthetists. Furthermore, this study has demonstrated that nurses hold concerns about the legitimacy of their practice in situations when they are required to perform tasks outside of clinical practice guidelines. To address nurses' concerns, it is proposed that new guidelines could be developed, which address the unique circumstances in which sedation is used in the cardiac catheterisation laboratory.

Relevance to clinical practice
Nurses need to possess advanced knowledge and skills in monitoring for the adverse effects of sedation. Several challenges impact on nurses' ability to monitor patients during procedural sedation and analgesia. Preprocedural patient education about what to expect from sedation is essential.
Language eng
DOI 10.1111/jocn.12147
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Blackwell Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30059430

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Thu, 09 Jan 2014, 12:41:19 EST by Jane Moschetti

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