2.50
Hdl Handle:
http://hdl.handle.net/10755/157150
Category:
Abstract
Type:
Presentation
Title:
Nurse Certification, Education, and Experience Improve Sedation Management
Author(s):
Olson, DaiWai; Thoyre, Suzanne; Stoner, Charles; Zomorodi, Meg
Author Details:
DaiWai Olson, Duke University, Durham, North Carolina, USA, email: olson006@mc.duke.edu; Suzanne Thoyre; Charles Stoner; Meg Zomorodi
Abstract:
PURPOSE: The purpose of this study was to explore the impact of specific individual nurse characteristics (education, certification, experience) on sedative use in mechanically-ventilated neurologically-injured patients who required continuous intravenous sedation. BACKGROUND: Sedation management in the ICU is primarily the purview of the bedside staff nurse. This task relies heavily on the nurses' assessment skills which are developed through education and experience caring for ICU patients. Limited research has been conducted examining the characteristics of the nurse completing these assessments. The increasing focus on sedation assessment in the literature and the diversity of nurses in critical care units warrants further investigation of this topic. METHODS: This prospective randomized study explored demographic and educational criteria of 65 nurses working in a neurocritical care ICU. The nurse data was paired to patient data for 5536 hours of continuous IV sedation. Nurse data included highest degree, specialty certification, years of experience. Patients were randomized to receive sedation assessment using either the Ramsay Scale or the Ramsay Scale and BIS monitoring for their sedation assessments. Patient data included baseline demographics, total sedative volumes infused during the period of mechanical ventilation, and number of undersedation events. RESULTS: SAS v9.1 was used to explore the impact of specific nurse characteristics on sedation delivery. After controlling for patient weight, and group assignment, certified nurses (CCRN, CNRN) used significantly lower propofol infusion rates (16.7 versus 18.5 ml/hr; p < .0001). The highest level of education was a significant predictor of mean propofol use; ADN 21.8 ml/hr, BSN 17.2 ml/hr, MSN 14.9 ml/hr, and PhD 12.1 ml/hr. There was no difference (p = .80) in undersedation events by nurse experience. Multivariate regression models demonstrated that nursing experience and critical care experience were significant (p<.0001) for predicting sedation use (greater experience = less sedative use). CONCLUSIONS: The contribution of individual nurses is important and measurable. These data provide solid evidence that nurse certification and education impact patient level outcomes. Nurses with higher educational degrees, specialty certification, and more experience used significantly less sedation than their counterparts with no difference in undersedation events outcome. This study highlights the need to include nurse variables in future research exploring interventions in critical care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleNurse Certification, Education, and Experience Improve Sedation Managementen_GB
dc.contributor.authorOlson, DaiWaien_GB
dc.contributor.authorThoyre, Suzanneen_GB
dc.contributor.authorStoner, Charlesen_GB
dc.contributor.authorZomorodi, Megen_GB
dc.author.detailsDaiWai Olson, Duke University, Durham, North Carolina, USA, email: olson006@mc.duke.edu; Suzanne Thoyre; Charles Stoner; Meg Zomorodien_GB
dc.identifier.urihttp://hdl.handle.net/10755/157150-
dc.description.abstractPURPOSE: The purpose of this study was to explore the impact of specific individual nurse characteristics (education, certification, experience) on sedative use in mechanically-ventilated neurologically-injured patients who required continuous intravenous sedation. BACKGROUND: Sedation management in the ICU is primarily the purview of the bedside staff nurse. This task relies heavily on the nurses' assessment skills which are developed through education and experience caring for ICU patients. Limited research has been conducted examining the characteristics of the nurse completing these assessments. The increasing focus on sedation assessment in the literature and the diversity of nurses in critical care units warrants further investigation of this topic. METHODS: This prospective randomized study explored demographic and educational criteria of 65 nurses working in a neurocritical care ICU. The nurse data was paired to patient data for 5536 hours of continuous IV sedation. Nurse data included highest degree, specialty certification, years of experience. Patients were randomized to receive sedation assessment using either the Ramsay Scale or the Ramsay Scale and BIS monitoring for their sedation assessments. Patient data included baseline demographics, total sedative volumes infused during the period of mechanical ventilation, and number of undersedation events. RESULTS: SAS v9.1 was used to explore the impact of specific nurse characteristics on sedation delivery. After controlling for patient weight, and group assignment, certified nurses (CCRN, CNRN) used significantly lower propofol infusion rates (16.7 versus 18.5 ml/hr; p < .0001). The highest level of education was a significant predictor of mean propofol use; ADN 21.8 ml/hr, BSN 17.2 ml/hr, MSN 14.9 ml/hr, and PhD 12.1 ml/hr. There was no difference (p = .80) in undersedation events by nurse experience. Multivariate regression models demonstrated that nursing experience and critical care experience were significant (p<.0001) for predicting sedation use (greater experience = less sedative use). CONCLUSIONS: The contribution of individual nurses is important and measurable. These data provide solid evidence that nurse certification and education impact patient level outcomes. Nurses with higher educational degrees, specialty certification, and more experience used significantly less sedation than their counterparts with no difference in undersedation events outcome. This study highlights the need to include nurse variables in future research exploring interventions in critical care.en_GB
dc.date.available2011-10-26T19:27:57Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:27:57Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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