임상간호연구 (Journal of Korean Clinical Nursing Research)

  • 제24권1호
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  • Pages.74-84
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  • 2018
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  • 1598-9186(pISSN)
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  • 2287-3694(eISSN)
병원간호사회 (Hospital Nurses Association)
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집중치료실 간호사의 진정요법 지식과 간호실무 역량요인의 상관성 분석

Relationships between Sedation Knowledge and Nurse Practice Competences in Intensive Care Unit

  • 장혜주 (아주대학교병원) ;
  • 이주희 (연세대학교 간호대학.김모임간호학연구소) ;
  • 남애리나 (아주대학교병원) ;
  • 김희정 (연세대학교 간호대학.김모임간호학연구소)
  • Jang, Hyejoo (Department of Nursing, Ajou University Medical Center) ;
  • Lee, JuHee (College of Nursing.Mo-Im Kim Nursing Research Institute, Yonsei University) ;
  • Nam, Ae-Ri-Na (Department of Nursing, Ajou University Medical Center) ;
  • Kim, Heejung (College of Nursing.Mo-Im Kim Nursing Research Institute, Yonsei University)
  • 투고 : 2018.01.31
  • 심사 : 2018.02.20
  • 발행 : 2018.04.30
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초록

Purpose: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. Methods: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 Results: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. Conclusion: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.

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참고문헌

  1. Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical Care Medicine. 2013;41(1):263-306. https://doi.org/ 10.1097/CCM.0b013e3182783b72
  2. Brattebo G, Hofoss D, Flaatten H, Muri AK, Gjerde S, Plsek PE. Effect of a scoring system and protocol for sedation on duration of patients' need for ventilator support in a surgical intensive care unit. Quality & Safety in Health Care. 2004;13(3): 203-205. https://doi.org/10.1136/bmj.324.7350.1386
  3. Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Critical Care Medicine. 2002;30(1):119-141. https://doi.org/10.1097/00003246-200201000-00020
  4. Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients under- going mechanical ventilation. The New England Journal of Medicine. 2000;342(20):1471-1477. https://doi.org/10.1056/NEJM200005183422002
  5. Jun JH. Sedation in the intensive care unit. Korean Journal of Critical Care Medicine. 2004;19(1):1-7.
  6. Hughes CG, McGrane S, Pandharipande PP. Sedation in the intensive care setting. Clinical Pharmacology. 2012;4:53-63. https://doi.org/10.2147/CPAA.S26582
  7. Feeley K, Gardner A. Sedation and analgesia management for mechanically ventilated adults: Literature review, case study and recommendations for practice. Australian Critical Care. 2006;19(2):73-77. https://doi.org/10.1016/S1036-7314(06)80012-3
  8. Girard TD, Kress JP, Fuchs BD, Thomason JW, Schweickert WD, Pun BT, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated pa- tients in intensive care(awakening and breathing controlled trial): A randomised controlled trial. The Lancet. 2008;371 (9607):126-134. https://doi.org/10.1016/S0140-6736(08)60105-1
  9. Strom T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: A randomised trial. The Lancet. 2010;375(9713):475-480. https://doi.org/10.1016/S0140-6736(09)62072-9
  10. Mehta S, Burry L, Fischer S, Martinez-Motta JC, Hallett D, Bowman D, et al. Canadian survey of the use of sedatives, analgesics, and neuromuscular blocking agents in critically ill patients. Critical Care Medicine. 2006;34(2):374-380. https://doi.org/10.1097/01.CCM.0000196830.61965.F1
  11. Guttormson JL, Chlan L, Weinert C, Savik K. Factors influencing nurse sedation practices with mechanically ventilated patients: A U.S. national survey. Intensive and Critical Care Nursing. 2010;26(1):44-50. https://doi.org/10.1016/j.iccn.2009.10.004
  12. Berry E, Zecca H. Daily interruptions of sedation: A clinical approach to improve outcomes in critically ill patients. Critical Care Nurse. 2012;32(1):43-51. https://doi.org/10.4037/ccn2012599
  13. Egerod I. Uncertain terms of sedation in ICU. How nurses and physicians manage and describe sedation for mechanically ventilated patients. Journal of Clinical Nursing. 2002;11(6): 831-840. https://doi.org/10.1046/j.1365-2702.2002.00725.x
  14. Walker N, Gillen P. Investigating nurses' perceptions of their role in managing sedation in intensive care: An exploratory study. Intensive and Critical Care Nursing. 2006;22(6):338-345. https://doi.org/10.1016/j.iccn.2006.03.008
  15. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50(2):179-211. https://doi.org/10.1016/0749-5978(91)90020-T
  16. Devlin JW, Marquis F, Riker RR, Robbins T, Garpestad E, Fong JJ, et al. Combined didactic and scenario-based education improves the ability of intensive care unit staff to recognize delirium at the bedside. Critical Care. 2008;12(1):R19. https://doi.org/10.1186/cc6793
  17. Mehta S, Meade MO, Hynes P, Filate WA, Burry L, Hallett D, et al. A multicenter survey of Ontario intensive care unit nurses regarding the use of sedatives and analgesics for adults receiving mechanical ventilation. Journal of Critical Care. 2007; 22(3):191-196. https://doi.org/10.1016/j.jcrc.2006.11.006
  18. Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua YP, Tang LY. Sedation scoring and managing abilities of intensive care nurses post educational intervention. Nursing in Critical Care. 2017;22(3):141-149. https://doi.org/10.1111/nicc.12180
  19. Lynn MR. Determination and quantification of content validity. Nursing Research. 1986;35(6):382-385.
  20. Chung V, Wong E, Griffiths S. Content validity of the integrative medicine attitude questionnaire: Perspectives of a Hong Kong Chinese expert panel. The Journal of Alternative and Complementary Medicine. 2007;13(5):563-570. https://doi.org/10.1089/acm.2007.6222
  21. Kim YS, Lee HJ, Jeon SB. Management of pain and agitation for patients in the intensive care unit. Journal of Neurocritical Care. 2015;8(2):53-65. https://doi.org/10.18700/jnc.2015.8.2.53
  22. Weinert CR, Chlan L, Gross C. Sedating critically ill patients: Factors affecting nurses' delivery of sedative therapy. American Journal of Critical Care. 2001;10(3):156-165.
  23. You S. Comparisons of the nursing workforce with Japan, and the U.S. The Journal of Digital Policy and Management. 2013; 11(6):275-287.
  24. Aitken LM, Marshall AP, Elliott R, McKinley S. Critical care nurses' decision making: Sedation assessment and management in intensive care. Journal of Clinical Nursing. 2009;18 (1):36-45. https://doi.org/10.1111/j.1365-2702.2008.02318.x
  25. Aveyard H, Woolliams M. In whose best interests? Nurses' experiences of the administration of sedation in general medical wards in England: An application of the critical incident technique. International Journal of Nursing Studies. 2006;43 (8):929-939. https://doi.org/10.1016/j.ijnurstu.2005.11.021
  26. Ajzen I, Joyce N, Sheikh S, Cote NG. Knowledge and the prediction of behavior: The role of information accuracy inthe theory of planned behavior. Basic and Applied Social Psychology. 2011;33(2):101-117.https://doi.org/10.1080/01973533.2011.568834