Identification of the determinants of nurses’ intention to conduct clinical surveillance of inpatients at the peak of action of subcutaneous opioids
Introduction: Subcutaneous administration of opioids may cause episodes of respiratory depression leading to preventable deaths. Due to their efficacy, opioids remain the first-choice therapy for the relief of moderate to acute pain. However, more and more inpatients have one or more risk factors for respiratory depression that justifies clinical surveillance adapted to their condition. To ensure safe monitoring of inpatients, professional guidelines, coupled with organizational measures in the form of guidelines and nurse monitoring protocols, have been introduced. Despite the action taken, clinical surveillance remains inadequate, allowing us to assume that there are, beyond the organizational elements, individual determinants influencing nurse supervision. Objective: Identify the determinants of the intention of nurses to conduct clinical surveillance of adults in hospital during the peak action of subcutaneous opioids. Methods: Predictive correlational study among nurses of surgical and medicine units of a Quebec health facility (n = 104) through a self-reported questionnaire. Multiple regressions were carried out to identify the determinants associated with the intention to perform the desired behaviour. Results: Perceived control and professional standards have been identified as the key determinants of nurses’ intention to perform clinical surveillance associated with opioid at the time of peak effect. Discussion and conclusion: By identifying the individual determinants most likely to explain the intention to exercise appropriate surveillance at the peak of opioid action, this study helps to target clinical safety interventions.