Abstract:

Objective To investigate and explore the current status and relevant factors of nurses' sedation practice in cardiac intensive care units (CICU) for mechanically ventilated children with congenital heart diseases. Methods A cross-sectional survey was adopted and 275 CICU nurses of six pediatric CICU in Shanghai, Beijing, and Wuhan were investigated by the Nurse Sedation Practice Scale (Chinese version). Results Only in two CICUs (33.3%), sedation assessment tools were used for evaluating the sedation level of children. And 59.4%-81.6% of 217 nurses agreed that children's behavior (such as cough response, body movement, etc.) reflected their sedation level; 98.2% of nurses agreed that sedating mechanically ventilated patients was important for their comfort after heart operation; and only 48.8% of the nurses intended to sedate all intubated patients. About 62.1%-68.8% of nurses agreed that the knowledge and practice of colleagues influenced their sedation practice; 87.1% of the nurses agreed that their attitudes would influence the prescription of physicians. Then 62.9%, 60.2%, and 50.7% of nurses agreed that communication difficulty, nurse to patient ratio, and workload influenced the sedative administration. Nurses' attitude toward sedation, subjective norm, and perceived behavior control were significantly and positively correlated with their intent and actual practice of sedation (P<0.01). Conclusion CICU nurses were positive towards sedative administration for mechanically ventilated children with congenital heart disease after surgeries. Many factors were relevant to nurses sedation practice, such as nurses' attitude towards sedation, opinions of colleagues, and nurses' demographic characteristics. Some factors which are irrelevant to patients, such as clinical workload, might influence the nurses' sedation practice. The opinions of medical and nursing staffs towards sedation practice could influence their decision on sedation administration.

Key words: congenital heart disease, critical care nursing, sedation, survey