The Application of the Nurse-Led Sedation and Analgesia Management in ICU after Heart Surgeries

Rong Lu; Huiqing Song; Li Wang; Huan Xiong; Zhongbin Chen; Xiaoli Liu; Shixiu Wang; Caixia Xie; Ping Jia

doi:10.1155/2022/7706172

The Application of the Nurse-Led Sedation and Analgesia Management in ICU after Heart Surgeries

Evid Based Complement Alternat Med. 2022 Jul 5:2022:7706172. doi: 10.1155/2022/7706172. eCollection 2022.

Authors

Rong Lu^{1

2}, Huiqing Song³, Li Wang^{1

2}, Huan Xiong^{1

4}, Zhongbin Chen^{1

2}, Xiaoli Liu⁵, Shixiu Wang⁶, Caixia Xie^{2

7}, Ping Jia^{2

8}

Affiliations

¹ Department of SICU, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
² Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China.
³ Department of Nursing, Sichuan Provincial People's Hospital and QiongLai Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
⁴ Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
⁵ Department of ICU, Deyang People's Hospital, Deyang, Sichuan, China.
⁶ School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China.
⁷ Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
⁸ Department of NICU, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Abstract

Aim: Traditional sedation management consists of doctors adjusting the dosage of sedative drugs or adding other drugs in combination according to the evaluation of nurses; the nurses then execute the orders. The nurses' passive execution in the process is not the ideal model for continuous evaluation and observation of sedation. This study aims to investigate the application and effects of nurse-provided procedural sedation and analgesia for patients in intensive care unit.

Methods: The experimental group consisted of 354 heart surgery patients who received procedural sedation and analgesia from nurses from November 2020 to August 2021. The control group consisted of 301 patients who had had heart surgery and received the traditional sedation management program from January to October 2020. The differences in levels of the sedative effect, delirium, and unplanned extubation of patients between these two groups were compared.

Results: There were no significant differences in baseline characteristics between the two groups (P > 0.05). It was found that both insufficient sedation and excessive sedation decreased in the experimental group when compared to the control group, while the appropriate proportion of sedation increased (72.41% versus 37.98%); the difference was statistically significant (P < 0.05). The incidence of delirium was lower for patients in the experimental group than for patients in the control group (37.01% versus 66.45%); the difference was statistically significant (P < 0.05). The incidence of unplanned extubation caused by patient factors was lower for the experimental group than for the control group, but the difference was not statistically significant (P > 0.05).

Conclusion: The programmed sedation scheme led by nurses can improve the sedation effect and reduce the incidence of delirium. Implications for Practice. The management team gives the sedative goal and establishes the standard flowchart. The sedation management led by the nurse according to the goal and flowchart is better than the traditional sedation management.

Publication types

Retracted Publication