Safe for Some ICU Patients to Self-administer Medication

Safe for Some ICU Patients to Self-administer Medication

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Anxiety is one of the factors affecting patients in an intensive care unit. They’re in a serious condition in the first place, probably in a maze of tubing and surrounded by machines. They may be on a ventilator to help them breath. If they are conscious and alert, it’s not surprising that some patients find it difficult to remain relaxed. Medication may be administered to help them relax, but individuals differ in needs and doses. That’s why it would be helpful if they could self-administer a mild sedative by pushing a button as needed.

Linda Chlan, R.N., Ph.D.

A clinical trial has shown that such an approach would be safe for some patients. The findings appear in the current American Journal of Critical Care.

While more research is needed, the study led by Mayo’s associate dean of nursing research, Linda Chlan, R.N., Ph.D., found that some patients on ventilators were able to manage their own anxiety and relaxation just as well and just as safely as if a physician or nurse administered the medications. These patients were also less likely to experience delirium, but larger studies will be needed to explore the reasons why. A follow up NIH-funded clinical trial is now under way at Mayo Clinic and the University of Minnesota.

Seventeen ICU patients were randomly allocated to self-administer the sedative dexmedetomidine. Twenty other patients served as control participants and received the medications via usual clinical practice. The majority said they were satisfied with their ability to manage their anxiety and did at least as well as the control group overall. The study was funded by the National Institute of Nursing Research, National Institutes of Health, and Hospira, Inc.