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Patient comfort in the intensive care unit : a multicentre, binational point prevalence study of analgesia, sedation and delirium management

Elliot, Doug, Aitken, Leanne M., Bucknall, Tracey K., Seppelt, Ian M., Webb, Steven A. R., Weisbrodt, Leonie and McKinley, Sharon 2013, Patient comfort in the intensive care unit : a multicentre, binational point prevalence study of analgesia, sedation and delirium management, Critical care and resuscitation, vol. 15, no. 3, pp. 213-219.

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Title Patient comfort in the intensive care unit : a multicentre, binational point prevalence study of analgesia, sedation and delirium management
Author(s) Elliot, Doug
Aitken, Leanne M.
Bucknall, Tracey K.ORCID iD for Bucknall, Tracey K. orcid.org/0000-0001-9089-3583
Seppelt, Ian M.
Webb, Steven A. R.
Weisbrodt, Leonie
McKinley, Sharon
Journal name Critical care and resuscitation
Volume number 15
Issue number 3
Start page 213
End page 219
Total pages 7
Publisher Australasian Medical Publishing Company
Place of publication Sydney, N. S. W.
Publication date 2013-09
ISSN 1441-2772
Keyword(s) patient satisfaction
aged
cross-Sectional Studies
delirium
complications
psychology
conscious sedation
standards
middle-aged
epidemiology
Australia
New Zealand
pain
diagnosis
measurement
prevalence
treatment outcome
analgesia
intensive care units
pain management
Summary Objective: To measure the prevalence of assessment and management practices for analgesia, sedation and delirium in patients in Australian and New Zealand intensive care units.
Materials and Methods: We developed survey items from a modified Delphi panel and included them in a binational, point prevalence study. We used a standard case report form to capture retrospective patient data on management of analgesia, sedation and delirium at the end of a 4-hour period on the study day. Other data were collected during independent assessment of patient status and medication requirements.
Results: Data were collected on 569 patients in 41 ICUs. Pain assessment was documented in the 4 hours before study observation in 46% of patients. Of 319 assessable patients, 16% had moderate pain and 6% had severe pain. Routine sedation assessment using a scale was recorded in 63% of intubated and ventilated patients. When assessed, 38% were alert and calm, or drowsy and rousable, 22% were lightly to moderately sedated, 31% were deeply sedated (66% of these had a documented indication), and 9% were agitated or restless. Sedatives were titrated to a target level in 42% of patients. Routine assessment of delirium occurred in 3%, and at study assessment 9% had delirium. Wrist or arm restraints were used for 7% of patients.
Conclusions: Only two-thirds of sedated patients had their sedation levels formally assessed, half had pain assessed and very few had formal assessment of delirium. Our description of current practices, and other observational data, may help in planning further research in this area.
Language eng
Field of Research 111003 - Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 - Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2013, Australasian Medical Publishing Company
Persistent URL http://hdl.handle.net/10536/DRO/DU:30061163

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Mon, 03 Mar 2014, 10:25:32 EST by Nicky Hewitt

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