{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:36:25Z","timestamp":1787603785179,"version":"build-2736575974"},"reference-count":49,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intensive and Critical Care Nursing"],"published-print":{"date-parts":[[2025,8]]},"DOI":"10.1016\/j.iccn.2025.104047","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:53:02Z","timestamp":1747191182000},"page":"104047","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"special_numbering":"C","title":["Barriers and enablers in nurses implementing light sedation in intubated and ventilated children: A qualitative exploratory descriptive study"],"prefix":"10.1016","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7461-5659","authenticated-orcid":false,"given":"Abdul","family":"Qayum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Harnischfeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Waak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Plummer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.iccn.2025.104047_b0005","doi-asserted-by":"crossref","DOI":"10.1053\/j.sempedsurg.2014.11.011","article-title":"Sedation and analgesia in the ICU","author":"Zalieckas","year":"2015","journal-title":"Semin Pediatr Surg"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0010","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s44158-022-00036-9","article-title":"Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit","volume":"2","author":"Amigoni","year":"2022","journal-title":"J Anesthesia, Analgesia and Crit Care"},{"issue":"9","key":"10.1016\/j.iccn.2025.104047_b0015","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","author":"Devlin","year":"2018","journal-title":"Crit Care Med"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0020","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s13613-017-0256-7","article-title":"Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit","volume":"7","author":"Dreyfus","year":"2017","journal-title":"Ann Intensive Care"},{"issue":"5","key":"10.1016\/j.iccn.2025.104047_b0025","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1542\/pir.2014-0116","article-title":"Pediatric sedation management","volume":"37","author":"Barnes","year":"2016","journal-title":"Pediatrics Rev"},{"issue":"9","key":"10.1016\/j.iccn.2025.104047_b0030","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.3390\/jcm10091847","article-title":"Current state of analgesia and sedation in the pediatric intensive care unit","volume":"10","author":"Egbuta","year":"2021","journal-title":"J Clin Med"},{"issue":"6","key":"10.1016\/j.iccn.2025.104047_b0035","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1007\/s00134-016-4344-1","article-title":"Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals","volume":"42","author":"Harris","year":"2016","journal-title":"Intensive Care Med"},{"issue":"13\u201314","key":"10.1016\/j.iccn.2025.104047_b0040","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1111\/jocn.14345","article-title":"A literature review of comfort in the paediatric critical care patient","volume":"27","author":"Bosch-Alcaraz","year":"2018","journal-title":"J Clin Nurs"},{"issue":"3","key":"10.1016\/j.iccn.2025.104047_b0045","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/scs.12764","article-title":"Meaning and comfort factors in the paediatric intensive care unit from an adult perspective: a descriptive phenomenological study","volume":"34","author":"Bosch-Alcaraz","year":"2020","journal-title":"Scand J Caring Sci"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0050","doi-asserted-by":"crossref","first-page":"S314","DOI":"10.1097\/01.ccm.0001000900.80620.a2","article-title":"682: clinical factors associated with physical restraint use in critically ill children","volume":"52","author":"De Armas","year":"2024","journal-title":"Crit Care Med"},{"issue":"12","key":"10.1016\/j.iccn.2025.104047_b0055","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1111\/apa.12777","article-title":"High doses of benzodiazepine predict analgesic and sedative drug withdrawal syndrome in paediatric intensive care patients","volume":"103","author":"Amigoni","year":"2014","journal-title":"Acta Paediatr"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0060","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1097\/CCM.0000000000001953","article-title":"Patient, process, and system predictors of iatrogenic withdrawal syndrome in critically ill children","volume":"45","author":"Best","year":"2017","journal-title":"Crit Care Med"},{"issue":"4","key":"10.1016\/j.iccn.2025.104047_b0065","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.aucc.2021.06.004","article-title":"Midazolam exposure in the paediatric intensive care unit predicts acute post-traumatic stress symptoms in children","volume":"35","author":"Long","year":"2022","journal-title":"Aust Crit Care"},{"issue":"9","key":"10.1016\/j.iccn.2025.104047_b0070","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1097\/CCM.0000000000003194","article-title":"Benzodiazepines and development of delirium in critically ill children: estimating the causal effect","volume":"46","author":"Mody","year":"2018","journal-title":"Crit Care Med"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0075","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s43054-023-00191-w","article-title":"Sedation in pediatric intensive care unit and its impact on outcomes of ventilated children: a prospective observational study","volume":"71","author":"Shajan","year":"2023","journal-title":"Egyptian Pediatric Association Gazette"},{"issue":"5","key":"10.1016\/j.iccn.2025.104047_b0080","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jama.2021.10296","article-title":"Effect of a sedation and ventilator liberation protocol vs usual care on duration of invasive mechanical ventilation in pediatric intensive care units: a randomized clinical trial","volume":"326","author":"Blackwood","year":"2021","journal-title":"JAMA"},{"issue":"11","key":"10.1016\/j.iccn.2025.104047_b0085","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.4187\/respcare.09942","article-title":"Pediatric ventilation liberation: bundled extubation readiness and analgosedation pathways decrease mechanical ventilation duration and benzodiazepine exposure","volume":"67","author":"Loberger","year":"2022","journal-title":"Respir Care"},{"issue":"3","key":"10.1016\/j.iccn.2025.104047_b0090","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/CCM.0000000000002885","article-title":"Practice patterns and outcomes associated with early sedation depth in mechanically ventilated patients: a systematic review and meta-analysis","volume":"46","author":"Stephens","year":"2018","journal-title":"Crit Care Med"},{"key":"10.1016\/j.iccn.2025.104047_b0095","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.886334","article-title":"Modified ABCDEF-bundles for critically ill pediatric patients \u2013 what could they look like?","volume":"10","author":"Engel","year":"2022","journal-title":"Front Pediatr"},{"issue":"2","key":"10.1016\/j.iccn.2025.104047_b0100","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1097\/PCC.0000000000002873","article-title":"2022 society of critical care medicine clinical practice guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility","volume":"23","author":"Smith","year":"2022","journal-title":"Pediatr Crit Care Med"},{"issue":"3","key":"10.1016\/j.iccn.2025.104047_b0105","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s40124-020-00216-7","article-title":"The ICU liberation bundle and strategies for implementation in pediatrics","volume":"8","author":"Walz","year":"2020","journal-title":"Curr Pediatr Rep"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0110","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1186\/s12887-022-03232-2","article-title":"Every child, every day, back to play: the PICUstars protocol - implementation of a nurse-led PICU liberation program","volume":"22","author":"Waak","year":"2022","journal-title":"BMC Pediatr"},{"key":"10.1016\/j.iccn.2025.104047_b0115","series-title":"Pediatric Critical Care Medicine: a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","article-title":"Caring for critically ill children with the ICU liberation bundle (ABCDEF): results of the pediatric collaborative","author":"Lin","year":"2023"},{"issue":"5","key":"10.1016\/j.iccn.2025.104047_b0120","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/PCC.0000000000000350","article-title":"Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference","volume":"16","author":"Pediatric Acute Lung Injury Consensus Conference Group","year":"2015","journal-title":"Pediatr Crit Care Med"},{"issue":"5","key":"10.1016\/j.iccn.2025.104047_b0125","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/DCC.0000000000000491","article-title":"Pediatric critical care nurses' practices related to sedation and analgesia","volume":"40","author":"Hagstrom","year":"2021","journal-title":"Dimens Crit Care Nurs"},{"issue":"7","key":"10.1016\/j.iccn.2025.104047_b0130","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1097\/CCM.0000000000000326","article-title":"Sedation, sleep promotion, and delirium screening practices in the care of mechanically ventilated children: a wake-up call for the pediatric critical care community*","volume":"42","author":"Kudchadkar","year":"2014","journal-title":"Crit Care Med"},{"issue":"17","key":"10.1016\/j.iccn.2025.104047_b0135","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1111\/j.1365-2702.2009.02836.x","article-title":"Implementation of standard sedation management in paediatric intensive care: effective and feasible?","volume":"18","author":"Ista","year":"2009","journal-title":"J Clin Nurs"},{"issue":"4","key":"10.1016\/j.iccn.2025.104047_b0140","doi-asserted-by":"crossref","first-page":"255","DOI":"10.4037\/ajcc2019526","article-title":"Nurses' attitudes and practices related to sedation: a national survey","volume":"28","author":"Guttormson","year":"2019","journal-title":"Am J Crit Care"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0145","article-title":"Defining exploratory-descriptive qualitative (EDQ) research and considering its application to healthcare","volume":"4","author":"Hunter","year":"2019","journal-title":"J Nurs Health Care"},{"issue":"6","key":"10.1016\/j.iccn.2025.104047_b0150","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"10.1016\/j.iccn.2025.104047_b0155","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0160","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1186\/s12889-021-11548-4","article-title":"Barriers and facilitators for treatment and control of high blood pressure among hypertensive patients in Kathmandu, Nepal: a qualitative study informed by COM-B model of behavior change","volume":"21","author":"Bhandari","year":"2021","journal-title":"BMC Public Health"},{"key":"10.1016\/j.iccn.2025.104047_b0165","doi-asserted-by":"crossref","DOI":"10.1111\/bjhp.12605","article-title":"Using the COM-B model to characterize the barriers and facilitators of pre-exposure prophylaxis (PrEP) uptake in men who have sex with men","author":"Madhani","year":"2022","journal-title":"Br J Health Psychol"},{"issue":"3","key":"10.1016\/j.iccn.2025.104047_b0170","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/jar.12985","article-title":"Barriers and facilitators of physical activity in adolescents with intellectual disabilities: an analysis informed by the COM-B model","volume":"35","author":"McDermott","year":"2022","journal-title":"J Appl Res Intellect Disabil"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0175","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11648\/j.ajtas.20160501.11","article-title":"Comparison of convenience sampling and purposive sampling","volume":"5","author":"Etikan","year":"2016","journal-title":"Am J Theor Appl Stat"},{"issue":"7","key":"10.1016\/j.iccn.2025.104047_b0180","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1038\/sj.bdj.2018.815","article-title":"Interviews and focus groups in qualitative research: an update for the digital age","volume":"225","author":"Gill","year":"2018","journal-title":"Br Dent J"},{"issue":"1","key":"10.1016\/j.iccn.2025.104047_b0185","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/2041-210X.12860","article-title":"The use of focus group discussion methodology: Insights from two decades of application in conservation","volume":"9","author":"Nyumba","year":"2018","journal-title":"Methods Ecol Evol"},{"key":"10.1016\/j.iccn.2025.104047_b0190","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: A systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Soc Sci Med"},{"key":"10.1016\/j.iccn.2025.104047_b0195","series-title":"Thematic analysis: A practical guide","author":"Braun","year":"2022"},{"key":"10.1016\/j.iccn.2025.104047_b0200","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.amsu.2020.07.017","article-title":"Medical negligence-Key cases and application of legislation","volume":"57","author":"Cheluvappa","year":"2020","journal-title":"Annals of Medicine and Surgery"},{"issue":"3","key":"10.1016\/j.iccn.2025.104047_b0205","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.aucc.2018.02.001","article-title":"\u201cSedation is tricky\u201d: A qualitative content analysis of nurses' perceptions of sedation administration in mechanically ventilated intensive care unit patients","volume":"31","author":"Hetland","year":"2018","journal-title":"Aust Crit Care"},{"issue":"5","key":"10.1016\/j.iccn.2025.104047_b0210","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/nicc.12426","article-title":"The sedation practices of paediatric intensive care unit nurses and the influencing factors in China","volume":"24","author":"Liu","year":"2019","journal-title":"Nurs Crit Care"},{"issue":"9","key":"10.1016\/j.iccn.2025.104047_b0215","doi-asserted-by":"crossref","first-page":"S116","DOI":"10.1097\/CCM.0b013e3182a17064","article-title":"Implementing the awakening and breathing coordination, delirium monitoring\/management, and early exercise\/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines","volume":"41","author":"Balas","year":"2013","journal-title":"Crit Care Med"},{"key":"10.1016\/j.iccn.2025.104047_b0220","unstructured":"Australian College of Critical Care Nurses [ACCCN]. Workforce Standards for Intensive Care Nursing. Melbourne, ACCCN Ltd.; 2016. https:\/\/acccn.com.au\/wp-content\/uploads\/Workforce-Standards.pdf."},{"key":"10.1016\/j.iccn.2025.104047_b0225","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2023.104601","article-title":"Costs and cost-effectiveness of improved nurse staffing levels and skill mix in acute hospitals: A systematic review","volume":"147","author":"Griffiths","year":"2023","journal-title":"Int J Nurs Stud"},{"key":"10.1016\/j.iccn.2025.104047_b0230","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.pedn.2019.10.013","article-title":"Impact of pediatric critical illness and injury on families: an updated systematic review","volume":"51","author":"Abela","year":"2020","journal-title":"J Pediatr Nurs"},{"issue":"2","key":"10.1016\/j.iccn.2025.104047_b0235","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/PCC.0000000000003385","article-title":"Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset","volume":"25","author":"Tager","year":"2024","journal-title":"Pediatr Crit Care Med"},{"issue":"6","key":"10.1016\/j.iccn.2025.104047_b0240","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s12098-021-04003-0","article-title":"A study of parental stressors, financial issues as stress factor, and the coping strategies in the PICU","volume":"89","author":"Upadhyay","year":"2022","journal-title":"Indian J Pediatr"},{"key":"10.1016\/j.iccn.2025.104047_b0245","doi-asserted-by":"crossref","DOI":"10.1002\/ppul.26884","article-title":"Tracheostomy and long-term invasive ventilation decision-making in children: A scoping review","author":"Mack","year":"2024","journal-title":"Pediatr Pulmonol"}],"container-title":["Intensive and Critical Care Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339725001089?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339725001089?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:38:10Z","timestamp":1769204290000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0964339725001089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":49,"alternative-id":["S0964339725001089"],"URL":"https:\/\/doi.org\/10.1016\/j.iccn.2025.104047","relation":{},"ISSN":["0964-3397"],"issn-type":[{"value":"0964-3397","type":"print"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Barriers and enablers in nurses implementing light sedation in intubated and ventilated children: A qualitative exploratory descriptive study","name":"articletitle","label":"Article Title"},{"value":"Intensive and Critical Care Nursing","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.iccn.2025.104047","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104047"}}