Critical Care Nurses’ Knowledge and Practice toward Sedation and Sedatives Dosing Approaches: A Multi-institution Cross-sectional Study in Saudi Arabia

Background: Sedation optimization in critically ill patients is crucial for patients’ outcomes. Managing and assessing sedation is one of the most important responsibilities of critical care nurses. However, the practical knowledge of critical care nurses in terms of sedation knowledge and practices for mechanically ventilated (MV) patients varies among critical care nurses within the same institution. Objectives: Identify the dosing approaches of sedative agents in critically ill patients and assess the practice and knowledge of sedation among intensive care unit (ICU) nurses. Methods: A multi-institutional, cross-sectional study included registered nurses who practiced in the ICUs of 12 tertiary hospitals across Saudi Arabia over 3 months in 2022. A modified version of a validated questionnaire that consisted of 44 questions was distributed electronically. The primary outcome was to assess the type of dosing weight used for sedative agents in ICU patients. The secondary outcomes include sedation knowledge and sedation practice assessment. Results: A total of 712 registered nurses participated in the questionnaire. The median age was 33 years (29–38), and 86.5% were female. The questionnaire revealed variation among nurses in the weight used for sedative agents (72.8% used actual body weight (ABW) vs. 20.2% used ideal body weight. More than 90% of the nurses agreed that sedation assessment was an important nursing responsibility. While 68.54% of the participants scored reasonable and moderate knowledge-wise, knowledge about the option of sedative agents used for sedation, the need for sedation for any MV patients, and the use of vital signs as marker for sedation adequacy were inconsistent. Conclusions: ABW as a dosing weight for sedative agents was a common practice for most ICU nurses in Saudi Arabia. Previous data has shown a disproportionate relationship between ABW used as a dosing weight for sedatives and pharmacokinetic variables. Several factors that may influence sedation practices have been identified, and these should be taken into account when developing sedation protocols and quality improvement efforts.