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

Elliott, D; Aitken, LM; Bucknall, TK; Seppelt, IM; Webb, SAR; Weisbrodt, L; McKinley, S

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

Elliott, D

Aitken, LM Bucknall, TK Seppelt, IM Webb, SAR Weisbrodt, L McKinley, S

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Publication Type:: Journal Article
Citation:: Critical Care and Resuscitation, 2013, 15 (3), pp. 213 - 219
Issue Date:: 2013-12-03

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Field	Value	Language
dc.contributor.author	Elliott, D https://orcid.org/0000-0002-6081-5442	en_US
dc.contributor.author	Aitken, LM	en_US
dc.contributor.author	Bucknall, TK	en_US
dc.contributor.author	Seppelt, IM	en_US
dc.contributor.author	Webb, SAR	en_US
dc.contributor.author	Weisbrodt, L	en_US
dc.contributor.author	McKinley, S	en_US
dc.date.issued	2013-12-03	en_US
dc.identifier.citation	Critical Care and Resuscitation, 2013, 15 (3), pp. 213 - 219	en_US
dc.identifier.issn	1441-2772	en_US
dc.identifier.uri	http://hdl.handle.net/10453/26750
dc.description.abstract	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.	en_US
dc.relation.ispartof	Critical Care and Resuscitation	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Delirium	en_US
dc.subject.mesh	Pain	en_US
dc.subject.mesh	Pain Measurement	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Analgesia	en_US
dc.subject.mesh	Conscious Sedation	en_US
dc.subject.mesh	Prevalence	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Intensive Care Units	en_US
dc.subject.mesh	Patient Satisfaction	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Pain Management	en_US
dc.title	Patient comfort in the intensive care unit: A multicentre, binational point prevalence study of analgesia, sedation and delirium management	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	15	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	15	en_US

Abstract:

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.

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http://hdl.handle.net/10453/26750