Sedation Management in Australian and New Zealand Intensive Care Units: Doctors’ and Nurses’ Practices and Opinions

2010 ◽  
Vol 19 (3) ◽  
pp. 285-295 ◽  
Author(s):  
Mark O’Connor ◽  
Tracey Bucknall ◽  
Elizabeth Manias
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Intensive Care Units ◽  
Response Rate ◽  
Survey Design ◽  
Assessment Tools ◽  
Personal Factors ◽  
Cross Sectional ◽  
Daily Interruption ◽  
Doctors And Nurses

Objective To explore the use of sedatives and analgesics, tools for scoring level of sedation, sedation and pain protocols, and daily interruptions in sedation in Australian and New Zealand intensive care units and to examine doctors’ and nurses’ opinions about the sedation management of critically ill patients. Methods A cross-sectional Internet-based survey design was used. In total, 2146 members of professional critical care organizations in Australia and New Zealand were e-mailed the survey during a 4-month period in 2006 through 2007. Results Of 348 members (16% response rate) who accessed the survey, 246 (71%) completed all sections. Morphine, fentanyl, midazolam, and propofol were the most commonly used medicines. Newer medicines, such as dexmedetomidine and remifentanil, and inhalant medications, such as nitrous oxide and isoflurane, were rarely used by most respondents. Respondents used protocols to manage sedatives (54%) and analgesics (51%), and sedation assessment tools were regularly used by 72%. A total of 62% reported daily interruption of sedation; 23% used daily interruption for more than 75% of patients. A disparity was evident between respondents’ opinions on how deeply patients were usually sedated in practice and how deeply patients should ideally be sedated. Conclusions Newer medications are used much less than are traditional sedatives and analgesics. Sedation protocols are increasingly used in Australasia, despite equivocal evidence supporting their use. Similarly, daily interruption of sedation is common in management of patients receiving mechanical ventilation. Research is needed to explore contextual and personal factors that may affect sedation management.

Staffing and Organisation of Nursing Care in Cardiac Intensive Care Units in Greece

2003 ◽  
Vol 2 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Anastasios Merkouris ◽  
Elizabeth D.E. Papathanassoglou ◽  
Dimitrios Pistolas ◽  
Vasileia Papagiannaki ◽  
John Floros ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Nurse Managers ◽  
Survey Design ◽  
Cross Sectional ◽  
Cardio Pulmonary Resuscitation ◽  
Service Training ◽  
Systematic Training ◽  
Cardiac Intensive Care

Purpose: To explore staffing and organisational characteristics of nursing care in cardiac intensive care units (CICUs) in Greece. Methodology: An exploratory descriptive survey design with additional cross-sectional comparisons was employed. A specifically developed survey-type questionnaire, addressed to nurse managers, was distributed to all CICUs in Greece. Results: The response rate was 76.2% ( N=32 units). Nursing staff per bed ratios over 24 h (whole-time equivalent) were very low and exhibited a mean of 1.25 (±0.53). The total registered nurse to assistance nurse (RN/AN) ratio was 2.74, but a lot of variability was observed and in many units ANs operated in RNs positions. Only 42% of the nurses had participated at in-service continuing education programs and a systematic training program in cardio pulmonary resuscitation (CPR) was provided in only 12 (37.5%) units. The reported frequencies at which specific technical tasks were performed autonomously by nurses varied substantially and reflected a medium to low level of practice autonomy; the most frequently reported tasks were: peripheral IV line insertion, CPR chest compression, titration of vasoactive drugs and administration of analgesics. Higher percentages of nurses had received in-service training associated with the likelihood of performance of several technical tasks ( P<0.03). Conclusions: Future studies need to explore the effect of these organisational characteristics on patient outcomes. The endorsement of nation-wide standards for nursing staffing and training in CICUs is imperative.

scholarly journals Paediatric admissions to a district general hospital adult intensive care unit over a six year period: A single centre retrospective case series, with review of practitioner confidence and competence in paediatric critical care

2021 ◽  
pp. 175114372110121
Author(s):  
Stephen A Spencer ◽  
Joanna S Gumley ◽  
Marcin Pachucki
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Series ◽  
Critically Ill Children ◽  
Single Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Paediatric Critical Care ◽  
Doctors And Nurses

Background Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. Methods all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. Results Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. Conclusion At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.

scholarly journals Nurses’ use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study

2021 ◽  
Vol 58 ◽  
pp. 102705
Author(s):  
Zeinab Kia ◽  
Maryam Allahbakhshian ◽  
Mahnaz Ilkhani ◽  
Malihe Nasiri ◽  
Atefeh Allahbakhshian
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Intensive Care Units ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Barriers of Palliative Care in Neonatal Intensive Care Units

2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban
Keyword(s):  
Palliative Care ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

Family visitation policies, facilities, and support in Australia and New Zealand intensive care units: A multicentre, registry-linked survey

2021 ◽  
Author(s):  
Alexis Tabah ◽  
Mahesh Ramanan ◽  
Rachel L. Bailey ◽  
Shaila Chavan ◽  
Stuart Baker ◽  
...  
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Intensive Care Units

Measuring efficiency in Australian and New Zealand paediatric intensive care units

2010 ◽  
Vol 36 (8) ◽  
pp. 1410-1416 ◽  
Author(s):  
Lahn D. Straney ◽  
Archie Clements ◽  
Jan Alexander ◽  
Anthony Slater
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Intensive Care Units ◽  
Paediatric Intensive Care ◽  
Measuring Efficiency ◽  
Paediatric Intensive Care Units

The battle over employers’ demand for “more flexibility”

2016 ◽  
Vol 38 (6) ◽  
pp. 886-906 ◽  
Author(s):  
Erling Rasmussen ◽  
Barry Foster ◽  
Deirdre Farr
Keyword(s):  
New Zealand ◽  
Survey Design ◽  
Postal Questionnaire ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Policy Makers ◽  
Content Type ◽  
Employer Attitudes ◽  
Legislative Changes ◽  
Employment Legislation

Purpose The purpose of this paper is to place empirical research on New Zealand employers’ attitudes to collective bargaining and legislative change within the context of the long running debate of flexibility. Design/methodology/approach A cross-sectional survey design using a self-administered postal questionnaire, covering private sector employers with ten or more staff and including employers within all 17 standard industry classification. To explore particular issues, an additional in-depth interviews were conducted of 25 employers participating in the survey. Findings It is found that employers support overwhelmingly recent legislative changes though there are variations across industries and firm sizes. There is also considerable variation in terms of which legislative changes are applied in the workplace. Despite fewer constraints on employer-determined flexibility, there was a rather puzzling finding that most employers still think that employment legislation is even balanced or favouring employees. Originality/value Cross-sectional survey findings of New Zealand employer attitudes to legislative changes are few and provide valuable data for policy makers, unions, employers and employment relations researchers. The paper also contributes to a more comprehensive understanding of pressures to increase employer-determined flexibility in many western countries.

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