By Chiegboka Ifeoma A
Sedative and analgesic pharmacotherapies are fundamental to the care of critically ill patients in order to facilitate the use of life-supporting therapies; ensure patients’ safety and comfort. Administration of these agents to achieve balanced sedation can be complex with unpredictable pharmacokinetics and significant side effects on patients. The Society of Critical Care Medicine (SCCM) in 2013 provided guidelines for the effective management of pain, agitation/sedation and delirium (PAD) of Intensive Care Unit (ICU) patients. Notwithstanding the proven benefits of the clinical guidelines, a substantial incidence of suboptimal analgesia and sedation is documented. This study assessed the knowledge, attitude and use of the SCCM 2013 recommended clinical guidelines in sedation-analgesia among professional care providers in intensive care units of teaching hospitals in Nigeria. Using cross sectional descriptive design, 288 (183 nurses and 105 doctors) purposively selected professional health care givers working in adult ICU of the Federal Teaching Hospitals in Nigeria were enlisted for the study. Questionnaire was used to collect data. Data was analyzed and t-test at 0.05 level of significance. The study revealed inadequate knowledge of PAD assessment scales. There is no significant difference in nurses and doctors’ knowledge about sedation-analgesia in management of critically-ill (p =.210). A significant difference (p< .001) exists in the practice level, with nurses’ level being greater than that of doctors. However, the knowledge level of nurses was found not be associated with their practice level (rs = -177, p=. 172). On the other hand, doctors’ knowledge was slightly associated with their practice level (rs = 311, p=.025). There was no significant difference in the attitude of nurses and doctors towards the recommended clinical guidelines. Overall, nurses and doctors’ knowledge, attitude and use of the recommended clinical guidelines of SCCM 2013 for the management of sedation-analgesia across different institutions revealed no significant difference between them (p>.05). The study revealed no significant difference between nurses and doctors in the level of satisfaction (p =.158), with the components of sedation-analgesia recommended clinical guidelines by SCCM 2013. Inclusion of sedation-analgesia management as a core curriculum in the various schools including nursing and medical schools as well as post graduate nursing and medical programmes was recommended.