{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:39:42Z","timestamp":1791221982446,"version":"4.1.0"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012866","name":"University of Calgary Cumming School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012866","id-type":"DOI","asserted-by":"publisher"}]}],"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":[[2026,6]]},"DOI":"10.1016\/j.iccn.2026.104351","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T01:30:06Z","timestamp":1770427806000},"page":"104351","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Facilitators and barriers to optimizing sedation practices in critically ill adult patients: A qualitative study"],"prefix":"10.1016","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7274-4903","authenticated-orcid":false,"given":"Theophany","family":"Eystathioy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Niven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanna","family":"Parsons-Leigh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa D.","family":"Burry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Petkovic-Wintemute","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten M.","family":"Fiest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2995-5527","authenticated-orcid":false,"given":"Natalia","family":"Jaworska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"11","key":"10.1016\/j.iccn.2026.104351_b0005","article-title":"Protocol-directed sedation versus non-protocol-directed sedation in mechanically ventilated intensive care adults and children","volume":"11","author":"Aitken","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0010","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems","volume":"12","author":"Atkins","year":"2017","journal-title":"Implement. Sci."},{"issue":"6","key":"10.1016\/j.iccn.2026.104351_b0015","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.jcrc.2013.06.019","article-title":"Implementation of a protocol for integrated management of pain, agitation, and delirium can improve clinical outcomes in the intensive care unit: a randomized clinical trial","volume":"28","author":"Mansouri","year":"2013","journal-title":"J. Crit. Care"},{"issue":"12","key":"10.1016\/j.iccn.2026.104351_b0020","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1097\/00003246-199912000-00001","article-title":"Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation","volume":"27","author":"Brook","year":"1999","journal-title":"Crit. Care Med."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0025","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/1748-5908-7-93","article-title":"A cross-country comparison of intensive care physicians\u2019 beliefs about their transfusion behaviour: a qualitative study using the theoretical domains framework","volume":"7","author":"Islam","year":"2012","journal-title":"Implement. Sci."},{"key":"10.1016\/j.iccn.2026.104351_b0030","doi-asserted-by":"crossref","first-page":"37 -","DOI":"10.1186\/1748-5908-7-37","article-title":"Validation of the theoretical domains framework for use in behaviour change and implementation research","volume":"7","author":"Cane","year":"2012","journal-title":"Implement. Sci. : IS"},{"issue":"4","key":"10.1016\/j.iccn.2026.104351_b0035","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1111\/nicc.12003","article-title":"Sedation practice in Nordic and non-Nordic ICUs: a European survey","volume":"18","author":"Egerod","year":"2013","journal-title":"Nurs. Crit. Care"},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0040","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jcrc.2008.03.037","article-title":"Perceived barriers to the use of sedation protocols and daily sedation interruption: a multidisciplinary survey","volume":"24","author":"Tanios","year":"2009","journal-title":"J. Crit. Care"},{"issue":"4","key":"10.1016\/j.iccn.2026.104351_b0045","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"Saunders","year":"2018","journal-title":"Qual. Quant."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0050","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4037\/ajcc2022768","article-title":"Effects of a national quality improvement collaborative on ABCDEF bundle implementation","volume":"31","author":"Balas","year":"2022","journal-title":"Am. J. Crit. Care"},{"issue":"3","key":"10.1016\/j.iccn.2026.104351_b0055","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":"15","key":"10.1016\/j.iccn.2026.104351_b0060","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1056\/NEJMoa2024922","article-title":"Dexmedetomidine or propofol for sedation in mechanically ventilated adults with sepsis","volume":"384","author":"Hughes","year":"2021","journal-title":"N. Engl. J. Med."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0065","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":"12","key":"10.1016\/j.iccn.2026.104351_b0070","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1097\/CCM.0000000000005980","article-title":"Evaluation of the impact of ABCDEF bundle compliance rates on postintensive care syndrome: a secondary analysis study","volume":"51","author":"Kawakami","year":"2023","journal-title":"Crit. Care Med."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0075","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1186\/s13054-022-04042-9","article-title":"A dual-center cohort study on the association between early deep sedation and clinical outcomes in mechanically ventilated patients during the COVID-19 pandemic: the COVID-SED study","volume":"26","author":"Stephens","year":"2022","journal-title":"Crit. Care"},{"key":"10.1016\/j.iccn.2026.104351_b0080","article-title":"What are the perceptions of intensive care staff about their sedation practices when caring for a mechanically ventilated patient?: a systematic mixed-methods review","volume":"4","author":"Varga","year":"2022","journal-title":"Int. J. Nurs. Stud. Adv."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0085","doi-asserted-by":"crossref","first-page":"30426","DOI":"10.3402\/jchimp.v6.30426","article-title":"Patient experiences during awake mechanical ventilation","volume":"6","author":"Prime","year":"2016","journal-title":"J. Commun. Hosp. Intern. Med. Perspect."},{"issue":"4","key":"10.1016\/j.iccn.2026.104351_b0090","doi-asserted-by":"crossref","DOI":"10.1136\/bmjoq-2023-002461","article-title":"Designing a behaviour change wheel guided implementation strategy for a hypoxaemic respiratory failure and ARDS care pathway that targets barriers","volume":"12","author":"Parhar","year":"2023","journal-title":"BMJ Open Qual."},{"issue":"6","key":"10.1016\/j.iccn.2026.104351_b0095","doi-asserted-by":"crossref","DOI":"10.1186\/cc8212","article-title":"The incidence of sub-optimal sedation in the ICU: a systematic review","volume":"13","author":"Jackson","year":"2009","journal-title":"Crit. Care"},{"issue":"22","key":"10.1016\/j.iccn.2026.104351_b0100","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1001\/jama.298.22.2644","article-title":"Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial","volume":"298","author":"Pandharipande","year":"2007","journal-title":"J. Am. Med. Assoc."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0105","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4037\/ajcc2018959","article-title":"Nurses' sedation practices during weaning of adults from mechanical ventilation in an intensive care unit","volume":"27","author":"Borkowska","year":"2018","journal-title":"Am. J. Crit. Care"},{"issue":"3","key":"10.1016\/j.iccn.2026.104351_b0110","first-page":"e0872","volume":"5","author":"Mion","year":"2023","journal-title":"Crit. Care Explor."},{"issue":"6","key":"10.1016\/j.iccn.2026.104351_b0115","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"},{"issue":"26","key":"10.1016\/j.iccn.2026.104351_b0120","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1056\/NEJMoa1808217","article-title":"Haloperidol and ziprasidone for treatment of delirium in critical illness","volume":"379","author":"Girard","year":"2018","journal-title":"N. Engl. J. Med."},{"issue":"12","key":"10.1016\/j.iccn.2026.104351_b0125","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1056\/NEJMoa1906759","article-title":"Nonsedation or light sedation in critically ill, mechanically ventilated patients","volume":"382","author":"Olsen","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.iccn.2026.104351_b0130","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-079789","article-title":"Management of pain and sedation in the intensive care unit","volume":"387","author":"Boncyk","year":"2024","journal-title":"BMJ"},{"key":"10.1016\/j.iccn.2026.104351_b0135","doi-asserted-by":"crossref","DOI":"10.1016\/j.iccn.2024.103685","article-title":"Factors that influence critical care nurses' management of sedation for ventilated patients in critical care: a qualitative study","volume":"83","author":"Macpherson","year":"2024","journal-title":"Intensive Crit. Care Nurs."},{"issue":"4","key":"10.1016\/j.iccn.2026.104351_b0140","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1348\/135910708X397025","article-title":"Evidence-based selection of theories for designing behaviour change interventions: using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour","volume":"14","author":"Francis","year":"2009","journal-title":"Br. J. Health Psychol."},{"issue":"4","key":"10.1016\/j.iccn.2026.104351_b0145","first-page":"695","article-title":"Keeping and using Reflective Journals in the Qualitative Research","volume":"13","author":"Ortlipp","year":"2008","journal-title":"Qual. Rep."},{"issue":"5","key":"10.1016\/j.iccn.2026.104351_b0150","doi-asserted-by":"crossref","DOI":"10.1097\/CCM.0b013e318168f82d","article-title":"A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit*","volume":"36","author":"Bucknall","year":"2008","journal-title":"Crit. Care Med."},{"key":"10.1016\/j.iccn.2026.104351_b0155","unstructured":"Creswell, J.W., Poth, C.N., 2018. Qualitative Inquiry and Research Design: Choosing Among Five Approaches. Thousand Oaks, California: SAGE Publications, Inc."},{"issue":"11","key":"10.1016\/j.iccn.2026.104351_b0160","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1097\/CCM.0000000000005951","article-title":"International analgesia and sedation weaning and withdrawal practices in critically ill adults: the adult iatrogenic withdrawal study in the ICU","volume":"51","author":"Bolesta","year":"2023","journal-title":"Crit. Care Med."},{"issue":"6","key":"10.1016\/j.iccn.2026.104351_b0165","article-title":"Early deep-to-light sedation versus continuous light sedation for ICU patients with mechanical ventilation: a cohort study","volume":"43","author":"Xu","year":"2024","journal-title":"Anaesth. Crit. Care Pain Med."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0170","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s12871-025-03137-4","article-title":"Early deep sedation was associated with post-hospital one-year mortality in critically ill surgical patients: a propensity-matched retrospective cohort study","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Anesthesiol.."},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0175","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J. Adv. Nurs."},{"issue":"10","key":"10.1016\/j.iccn.2026.104351_b0180","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1007\/s11606-023-08042-5","article-title":"Facilitators and barriers influencing antipsychotic medication prescribing and deprescribing practices in critically ill adult patients: a qualitative study","volume":"38","author":"Jaworska","year":"2023","journal-title":"J. Gen. Intern. Med."},{"issue":"2","key":"10.1016\/j.iccn.2026.104351_b0185","doi-asserted-by":"crossref","DOI":"10.1186\/cc8956","article-title":"A systematic review of the impact of sedation practice in the ICU on resource use, costs and patient safety","volume":"14","author":"Jackson","year":"2010","journal-title":"Crit. Care"},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0190","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/CCM.0000000000003482","article-title":"Caring for critically ill patients with the ABCDEF bundle: results of the ICU liberation collaborative in over 15,000 adults","volume":"47","author":"Pun","year":"2019","journal-title":"Crit. Care Med."},{"key":"10.1016\/j.iccn.2026.104351_b0195","article-title":"Nurse-led weaning protocols-a systematic review and meta-analysis","volume":"12","author":"Wang","year":"2025","journal-title":"Front. Med. (lausanne)"},{"issue":"1","key":"10.1016\/j.iccn.2026.104351_b0200","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s12871-017-0415-2","article-title":"Multicenter assessment of sedation and delirium practices in the intensive care units in Poland - is this common practice in Eastern Europe?","volume":"17","author":"Kotfis","year":"2017","journal-title":"BMC Anesthesiol."},{"issue":"9","key":"10.1016\/j.iccn.2026.104351_b0205","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."}],"container-title":["Intensive and Critical Care Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339726000194?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0964339726000194?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:57:37Z","timestamp":1783976257000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0964339726000194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":41,"alternative-id":["S0964339726000194"],"URL":"https:\/\/doi.org\/10.1016\/j.iccn.2026.104351","relation":{},"ISSN":["0964-3397"],"issn-type":[{"value":"0964-3397","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Facilitators and barriers to optimizing sedation practices in critically ill adult patients: A qualitative 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.2026.104351","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"104351"}}