{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:24:08Z","timestamp":1784917448011,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000777","name":"University of Leeds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000777","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical sedation is a requirement for mechanical ventilation for most patients admitted to the intensive care unit (ICU). Sedation can help minimise patient discomfort, pain and distress, but can lead to hypotension, bradycardia, prolonged ventilation and delirium. Improving sedation practice is key to improving sedation\u2010related patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to explore ICU staff experience with sedation practices and identify potential areas for improvement and innovation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Semi\u2010structured interview study exploring views, experiences and clinical decision\u2010making of ICU medical and nursing staff from two NHS adult ICUs in Yorkshire, England. Interviews were recorded to enable anonymous transcript production. Transcripts were coded using reflexive thematic analysis guided by Braun and Clarke's six\u2010stage method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>We interviewed 18 members of ICU medical and nursing staff and using thematic analysis four interrelated themes were identified. First, staff perception of sedation, including understanding and reasoning around sedation goals. Second, the impact that ICU culture has on sedation practices. Third, sedation education and training for clinical staff. Finally, motivation to change, aspects impacting the delivery of sedation practices on ICU and key considerations for innovating change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sedation practices in ICU are shaped by complex interactions between clinical framing, cultural norms, education and training and organisational pressures. Optimising sedation and implementing innovation require prioritisation of sedation as an active, goal\u2010directed treatment, supported by structured education and leadership engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>This analysis offers novel insights into barriers and facilitators to innovating sedation practices for mechanically ventilated patients, highlighting under\u2010prioritisation in clinical practice and training, cultural barriers and external influencers like staff retention and workload.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70348","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:21:52Z","timestamp":1768461712000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Barriers to Changing Sedation Practice for Patients Undergoing Mechanical Ventilation on the Intensive Care Unit: A Qualitative Interview Study of Clinical Staff"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3200-7114","authenticated-orcid":false,"given":"Nicholas D.","family":"Richards","sequence":"first","affiliation":[{"name":"Adult Critical Care, Leeds Teaching Hospitals NHS Trust  Leeds UK"},{"name":"Leeds Institute of Medical Research University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1978-5795","authenticated-orcid":false,"given":"Hilary L.","family":"Bekker","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181de125a"},{"key":"e_1_2_12_3_1","volume-title":"Intensive Care Society Review of Best Practice for Analgesia and Sedation in the Critical Care","author":"Whitehouse 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