LETTER OF INFORMATION AND CONSENT - HEALTHCARE PROFESSIONALS
Study Title: SAVE-ICU National Survey of Stakeholders: Use of Inhaled Anesthetics in Intensive Care: A survey evaluating sedation clinical practice, knowledge and experience of inhaled anesthetics.
Sponsor's Study ID: 2149
Sponsor: Sunnybrook Research Institute
Funders: Canadian Institute for Health Research (CIHR)
Principal Investigators:
Angela Jerath, MSc FRCPC, FANZCA, MD, BSc Sunnybrook Health Sciences Centre University of Toronto
Marat Slessarev, MD PhD FRCPC London Health Sciences Centre Western University
Letter of Consent
You are being asked to participate in a Canada-wide survey investigating the mediators influencing the use of inhaled anesthetics in critical care units as you are part of a key stakeholder group involved in formulating, administering, and/or managing inhalational anesthetics to patients in ICU/CCU: critical care physicians, nurses, respiratory therapists, pharmacists, anesthesia assistants, dieticians and department leadership. Your participation is instrumental for the success of this research study.
Purpose: The purpose of this study is to understand the barriers and facilitators that affect the use of inhaled volatile anesthetics. In addition to informing future research initiatives, this information will be used to develop policies and training to appropriately address challenges and pave the way for safe and effective use of inhalational anesthetics by ICU health care professionals.
We would like to collect your feedback on the study procedures. Your feedback is important and may be used to inform the design of a larger randomized controlled trial.
Procedures: If you choose to participate, you will be directed to an anonymous online survey. We will ask you to read the information provided and respond to survey questions. The survey is divided into 5 sections:
Section 1: Current sedation practice
Section 2: Inhaled anesthetic practice
Section 3: Knowledge/experience with using inhaled anesthetics
Section 4: Factors supporting Inhaled Anesthetics Use in Your ICU.
Section 5: Respondent and ICU Characteristics
Duration: We expect 50-300 participants to complete the survey over the next 6-9 months. You do not have to complete the survey if you don't want to.
Risks: There are no anticipated risks or discomforts associated with your participation.
Benefits: You may not directly benefit from participating in this study but we hope the information learned from this study will help other people in the future.
Compensation: You will not be compensated for your participation.
Confidentiality & Data Protection: Providing your feedback is voluntary and your responses will be kept confidential. Your survey responses will be anonymous. While we do our best to protect your information there is no guarantee that we will be able to do so. The inclusion of your role in the circle of care and date of survey completion may allow someone to link the data and identify you.
Once you submit your responses, the data will be saved into REDCap, a password-protected, secure electronic database, located on a Sunnybrook server in Toronto, Canada. Your survey responses will be saved for 10 years.
Rights: Your participation in this study is voluntary. You may decide not to participate. You have the right to not answer individual questions or to withdraw at any time. If you decide to withdraw from the study, the information that was collected prior will still be used as the researchers will be unable to identify individual participant responses .You do not waive any legal rights by consenting to this study.
If you have any questions regarding your rights as a research participant, you may contact the Sunnybrook Health Sciences Research Ethics Board Office:
Sunnybrook Health Sciences Research Ethics Board
Monday to Friday, 9:00 a.m. to 5:00 p.m.
416-480-6100 ext. 688144
The REB is a group of people who oversee the ethical conduct of research studies. The REB is not part of the study team. Everything that you discuss will be kept confidential.
Consent: You indicate your voluntary agreement to participate by clicking "I agree" and completing the survey.
I do not agree
I agree
SAVE-ICU National Survey of Stakeholders: Use of Inhaled Anesthetics in Intensive Care: A survey evaluating sedation clinical practice, knowledge and experience of inhaled anesthetics. Introduction
Inhaled volatile anesthetics are a new class of medications used in the ICU to provide sedation to mechanically ventilated patients and to support the management of specific conditions such as severe asthma or seizure disorders. These medications are administered through unique delivery systems and involve the collaboration of physicians (MD), nurses (RN), and respiratory therapy (RT) ICU staff.
As inhaled anesthetics are a relatively new addition to the ICU environment, this survey aims to assess your:
• Current sedation practices • Clinical experience and knowledge regarding the use of inhalational anesthetics for ICU patients • Local factors influencing the use of inhalational anesthetics This survey collects no personal identifying information, and all responses will be kept confidential.
Section 1: Current Sedation Practice In this section we ask a few questions to understand your current sedation care practices in your ICU.
Section 2: Current Sedation Practice In this section we ask a few questions to understand clinical practices around inhaled anesthetic delivery in your ICU.
2.1 Has your ICU had any experience using inhaled volatile anesthetics?
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Yes
No
Don't know
2.2 Which inhaled volatile agents have you used in your ICU? Please select all that apply.
*
check all that apply
The option "
2.3 If inhaled anesthetics are used in your ICU, how are they titrated? Please select all that apply.
*
check all that apply
The option "
2.4 What equipment do you use to deliver inhaled anesthetics? Please select all that apply.
*
check all that apply
2.5 Do you have written protocols and/or order sets for administration and titration of inhaled anesthetics?
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Yes
No
Don't know
The option "
2.6 Who is involved in preparing the inhaled volatile anesthetic (i.e., drawing up the drug or filling a vaporizer) for administration to the patient in your ICU? Please select all that apply.
*
check all that apply
The option "
2.7 Who manages inhaled volatile anesthetic delivery equipment (e.g., setting up vaporizer and scavenging equipment) in your unit? Please select all that apply.
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check all that apply
The option "
2.8 Who titrates the inhaled volatile anesthetic dose changes? Please select all that apply.
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check all that apply
2.9 Overall, how comfortable do you feel delivering inhaled volatile anesthetics to patients in the ICU? Please select one of the following options:
*
1 (very uncomfortable)
2 (uncomfortable)
3 (neutral)
4 (comfortable)
5 (very comfortable)
2.10 Compared to intravenous (IV) sedatives (e.g., benzodiazepines, propofol, others), how would you rate the quality of sedation provided by inhaled volatile anesthetics for most patients?
Please select one of the following options:
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1 (much worse than IV agents)
2 (worse than IV agents)
3 (same as IV agents)
4 (better than IV agents)
5 (much better than IV agents)
2.11 Compared to intravenous (IV) sedatives (e.g., benzodiazepines, propofol, others), how would you rate the usability of the equipment required to deliver inhaled volatile anesthetics in the ICU. Please select one of the following options:
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1 (much harder than pumps for IV agents)
2 (harder than pumps for IV agents)
3 (same as pumps for IV agents)
4 (easier than pumps for IV agents)
5 (much easier than pumps for IV agents)
6 (don't know)
2.12 In your ICU, are environmental (atmospheric) levels of inhaled anesthetics tested either periodically or continuously?
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Yes
No
Don't know
2.13 Do you know the method of ICU scavenging in place for capturing anesthetic waste gases from the ventilator exhaust in your unit?
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Active scavenging (e.g., attachment to wall suction)
Passive scavenging (e.g., attachment of charcoal, Flurabsorb or Deltasorb canister)
Combination of active and passive scavenging (e.g., combined use of canister and wall outlet suction)
Don't know
2.14a Many ICU patients on inhaled anesthetic sedation require transport within the hospital to CT scan. In this scenario, how does your ICU team manage sedation during transportation? Please select one of the following options:
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Keep them on inhaled anesthetic agent for duration of transport
Temporarily stop inhaled anesthetic and run intravenous sedation for duration of transport
Run both inhaled and intravenous sedation for duration of transport
Don't know
Not Applicable
2.14b If you answered 'Keep them on inhaled anesthetic agent for duration of transport' for above question, do you scavenge (or capture) anesthetic waste gases from the ventilator on transport?
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Always
Sometimes
Never
Don't know
Not Applicable
2.15 Is your ICU part of an inhalational volatile trial (e.g., SAVE-ICU ABOVE
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Yes No
Section 3: Knowledge and Experience with Using Inhaled Anesthetics In this section we ask a few questions to assess your general knowledge and experience with using inhaled anesthetics.
3.1 What patient populations do you perceive to benefit from inhaled anesthetic use? Please select all that apply.
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check all that apply
3.4a Have you received any training using inhaled anesthetics?
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Yes No
3.4b If you answered yes to question 3.4a, how did you receive training and education around inhaled volatile anesthetics? Please select all that apply.
*
check all that apply
3.4c If you answered yes to question 3.4a, do you feel you have received enough training and are comfortable using inhaled anesthetics?
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Yes No
Section 4: Factors supporting Inhaled Anesthetics Use in Your ICU. This section explores factors that you perceive are important to ENABLE use of inhaled anesthetic drugs in your ICU environment.
4.2 Please add any additional items that you think are important to the use of inhalational anesthetics and not included in question 4.1.
Section 5: Respondent and ICU Characteristics 5.1 What is your professional designation?
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Medical Doctor
Registered Nurse (includes Nurse Practitioner, Nurse Administrator, Clinical Nurse Specialist)
Registered Respiratory Therapist (RRT)
5.1a If you are a medical doctor, what is your primary specialty?
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Anesthesia
Internal medicine or subspecialty
Surgery (any)
Emergency medicine
Neurology
Paediatrics
Other (please specify):
The option "
5.2a If you are a medical doctor, do you have non-clinical responsibilities in the ICU? Select all that apply.
*
check all that apply
The option "
5.2b If you are a nurse, do you have non-clinical responsibilities in the ICU? Select all that apply.
*
check all that apply
The option "
5.2c If you are a registered respiratory therapist (RRT), do you have non-clinical responsibilities in the ICU? Select all that apply
*
check all that apply
5.3 What proportion of time do you spend working clinically in your ICU?
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< 25%
25%-50%
50%-75%
75%-100%
5.4 Please provide years of independent practice in critical care
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<5y
5-10y
10-20y
>20y
5.5 Which province or territory do you currently practice in?
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Alberta (AL) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrador (NL) Northwest Territories (NT) Nova Scotia (NS) Nunavut (NU) Ontario (ON) Prince Edward Island (PE) Quebec (QC) Saskatchewan (SK) Yukon (YT)
5.6 What type of patients do you take care of?
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Adults (>18y)
Paediatrics (<18y)
Both
5.7 What is your practice setting?
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Teaching hospital
Non-teaching hospital
5.8 What type of patients are cared for in the ICU where you work (tick all that apply)?
*
check all that apply
5.9 How many level 1, 2 and 3 ICU beds are there in your ICU? Please provide your best estimate as a single number, for example 25 beds.
*
Please enter number beds
5.10 Which sex was assigned to you at birth?
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Male
Female
I prefer not to answer
The option "
5.11 Which term(s) best describe your current gender identity? (Select the option(s) that apply to you.)
*
check all that apply
5.12 Do you identify as Indigenous, that is, First Nation (North American Indian), Métis, or Inuk (Inuit)?
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Yes
No
I prefer not to answer
The option "
5.13 Select the population group(s) you identify with. Note: if you answered "Yes" to question 5.11 (i.e., you are an Indigenous person), select "Population group not listed above" for this question. You can also select from the list any other population group that applies to you.
*
Arab
Black
Chinese
Filipino
Japanese
Korean
Latin American
South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai, etc.)
West Asian (e.g., Iranian, Afghan, etc.)
White
Population group not listed above. I identify as: (option to specify)
I prefer not to answer
check all that apply