A survey of knowledge, attitude & practice of sedation & analgesia among nurses working in KNH ICU

Abstract

Background Sedation and analgesia are necessary for the alleviation of anxiety and pain so as to improve patient comfort and facilitate medical interventions such as mechanical ventilation, tracheal intubation and other invasive procedures in the Intensive Care Unit. Objective To explore the knowledge, attitude and practice of sedation and analgesia amongst nurses working in the Kenyatta National Hospital Intensive Care Unit. Methods A cross sectional descriptive study of the knowledge, attitude and practice of sedation and analgesia amongst nurses working in the Kenyatta National Hospital Intensive Care Unit. The target population included all nurses working in the KNH CCU. Data was collected using a pre-tested questionnaire. The hardcopies were filed after transcription of the information into a Microsoft Excel™ database. Data was analyzed using the Statistical Package for Social Sciences (version 11.0; SPSS, Chicago, IL) Results There was a 90% response rate. Most respondents were aged between 30 and 35 years of age.75% of the respondents had a higher diploma in critical care.40.7% the respondents had practiced as nurses for between six and ten years while 60.2% of them had practiced as intensive care nurses for less than 5 years. 75.94% of the respondents correctly answered most questions meant to assess current knowledge of analgesia and sedation management in the ICU. In the management of anxiety, an average of 68% of the respondents who consistently reduced noise, switched off lights, comforted patients and used pharmacological agents, had attained a Higher Diploma in Critical Care. Of these, those who consistently reduced noise (n = 3out of 5, 60%), switched off lights (n = 2 out of 2, 50%), comforted IX patients (n = 36 out of 57, 63.2%) and used pharmacological agents (n = 18 out of 24, 75%) had less than five years work experience in the 1CU. Similarly in the management of pain it was shown that on average 80% of the respondents who consistently explained the procedure, turned, massaged patient and used pharmacological agents had a Higher Diploma in Critical Care. Further, most of these respondents who consistently explained the procedure (n = 23 out of 35, 65.7%), turned patient (n= 36 out of 58, 62%), massaged patient (n = 19 out of 28, 67.8%) and used pharmacological agents (n = 30 out of 46, 65.2%) were nurses who had practiced in the ICU for less than five years. Conclusion Whereas the knowledge of sedation and analgesia management by the nurses in this survey is generally good there is a disconnect between their level of knowledge and their practice. The nurses indicated that it is very important to standardize the approach towards sedation and analgesia management preferably through a nurse driven protocol.