Nurse education regarding agitated patients and its effects on clinical practice
Leyla Özdemir
Hacettepe University School of Nursing Ankara, Turkey
Erdem Karabulut
Hacettepe University Department of Biostatistics, Medical Faculty Ankara, Turkey
PP: 119 - 128
Abstract
This study identified the impact of an education program on nurses' practices for agitated patients and documented the changes in practice after completion of the training. Eighteen cardiac intensive care nurses were included to the study. Prior to nurses' participation in an education program, a pre-test indicating nurses' current practices for forty agitated patients was evaluated with the 'Nurse Practice Form'. After the pre-test data collection period was completed, the two-day training program on caring for agitated patients was conducted. The last step of the study was evaluation of post-test nurses' practices for forty agitated patients using the 'Nurse Practice Form'. The findings indicated that instead of pre-test nurses' use of physical restraints for controlling agitated patients without a physician order, none of post-test nurses applied them. The training program provided nurses the knowledge and skills needed to evaluate and to manage the causes of agitation.
Keywords
agitation, clinical practice, education, intensive care unit, nursing, restraints
References
Aari RL, Tarja S, Helena L-K (2007) Competence in intensive and critical care nursing: a literature review. Intensive and Critical Care Nursing 24: 78-89.
Aitken LM, Marshall AP, Elliott R, McKinley S (2008) Critical care nurses' decision making: sedation assessment and management in intensive care. Journal of Clinical Nursing 18: 36-45.
Bray K, Hill K, Robson W, Leaver G, Walker N, O'Leary M, et al (2004) British Association of Critical Care Nurses position statement on the use of restraints in adult critical care units. Nursing in Critical Care 9(5): 199-211.
Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF, et al (2006) Impact of systemic evaluation of pain and agitation in an intensive care unit. Critical Care Medicine 34(6): 1691-1699.
Cohen-Mansfield J (2001) Nonpharmacological interventions for inappropriate behaviours in dementia: a summary, review, and critique. American Journal of Geriatric Psychiatry 9: 361-381.
Cohen I L, Gallagher T, James MD, Pohlman A S, Dasta J F, Abraham E, et al (2002) Management of the agitated intensive care unit patient. Critical Care Medicine 30(1): S97-S123.
Demir A (2007) Nurses' use of physical restraints in four Turkish hospitals. Journal Nursing Scholarship 39(1): 38-45.
El-Masri M, Fox-Wasylyshyn SM (2007) Nurses' role with families: perceptions of ICU nurses. Intensive and Critical Care Nursing 23: 43-50.
Happ MB (2000) Preventing treatment interference: the nurse's role in maintaining technologic devices. Heart & Lung 29(1): 60-69.
Jaber S, Chanques G, Altairac C, Sebbana M, Vergne C, Perrigault P-F, et al (2005) A prospective study of agitation in a medical-surgical ICU. Chest 128(4): 2749-2757.
Keatinge D, Scarfe C, Bellchambers H, McGee J, Oakham R, Probert C, et al (2000). The manifestation and nursing management of agitation in institutionalised residents with dementia. International Journal of Nursing Practice 6: 16-25.
Kozier B, Erb A, Berman AJ, Burke K (2000) Activity and exercise, in Jutson SV (ed) Fundamentals of Nursing, 6th edition, Prince-Hall Inc, USA.
Maccioli GA, Dorman T, Brown BR, Mazuski JE, McLean BA, Kuszaj JM, et al (2003) Clinical practice guidelines for the maintenance of patients' physical safety in the intensive care unit: Use of restraining therapies-American College of Critical Care Medicine Task Force 2001-2002. Critical Care Medicine 31(11): 2665-2676.
Martin B, Mathisen L (2005) Use of physical restraints in adult critical care: a bicultural study. American Journal of Critical Care 14(4): 133-142.
Mott S, Poole J, Kenrick M (2005) Physical and chemical restraints in acute care: their potential impact on the rehabilitation of older people. International Journal of Nursing Practice 11: 95-101.
Paterson B (2006) Developing a perspective on restraint and the least intrusive intervention. British Journal of Nursing 15(22): 1235-1241.
Poole J (2003) Poole's algorithm: nursing management of disturbed behaviour in older people-the evidence. Australian Journal of Advanced Nursing 20: 38-43.
Richards KC, Gibson R, Overton-McCoy AL (2000) Effects of massage in acute and critical care. American Association of Colleges of Nursing Clinical Issues: Advanced Practice in Acute Critical Care 11: 77-96.
Riker RR, Picard JT, Fraser GL (1999) Prospective evaluation the Sedation-Agitation Scale for adult critically ill patients. Critical Care Medicine 27(7): 1325-1329.
Sessler CN, Varney K (2008) Patient-focused sedation and analgesia in the ICU. Chest 133(2): 552-565.
Tabloski P, Adamson L, Karwacki E, William F (2004) A comparison of subjective and objective agitation ratings in nursing home residents with dementia. The Gerontologist 44(1): 258.
Testad I, Aasland AM, Aarsland D (2005) The effect of staff training on the use of restraint in dementia: a single-blind randomized controlled trial. International Journal of Geriatric Psychiatry 20: 587-590.
Waterhouse C (2005) Guidelines on use of restraints in neuroscience settings. Nursing Times 102(23): 28-29.
Weir S & O'Neill A (2008) Experiences of intensive care nurses assessing sedation/agitation in critically ill patients. Nursing in Critical Care 13(4): 185-194.
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