Other Titles
Current ICU Practices and Barriers to Implementing CALM ICU [Poster Title]
Abstract
Background: Agitation in the intensive care unit (ICU) can compromise patient safety, prolong recovery, and contribute to staff injuries. While pharmacological interventions are sometimes necessary, they carry risks such as oversedation, delirium, and prolonged mechanical ventilation. The CALM ICU guideline provides recommendations for the non-pharmacological prevention and management of patient agitation. However, guidance on how to implement these strategies in complex ICU environments remains limited.
Aim: To explore current ICU practices and stakeholder perspectives on the barriers and facilitators to implementing non-pharmacological strategies for managing agitation.
Methods: This mixed-methods study used an exploratory sequential design guided by the i-PARIHS framework. Conducted in a 32-bed tertiary ICU in Australia, data collection included a cross-sectional survey, focus groups with ICU clinicians and semi-structured interviews with former patients and family members. The survey explored current practices, use of non-pharmacological strategies, clinicians’ knowledge and attitudes, and perceived barriers and facilitators to guideline uptake. Interviews explored experiences of agitation management, involvement in care, communication, and support needs. Quantitative data were analysed descriptively and with appropriate statistical tests, while qualitative data were analysed thematically guided by the i-PARIHS constructs.
Results: Data analysis is currently underway, with results expected by April 2026. Findings from this study will directly inform a co-design study, in which interdisciplinary clinicians, patients, and family representatives will collaboratively develop a tailored implementation framework for the CALM ICU guideline.
Conclusion: This study provides a foundation for improving the management of patient agitation in the ICU by identifying practice gaps and stakeholder perspectives. Using a structured knowledge translation approach, it aims to support the uptake of the CALM ICU guidelines and promote sustainable practice change. The findings may also inform broader efforts to adapt and implement the guidelines across diverse ICU settings, nationally and internationally.
Notes
References:
Adams, A. M. N., Chamberlain, D., Brun Thorup, C., Maiden, J. M., Waite, C., Dafny, H. A., Bruce, K., & Conroy, T. (2025). Patient agitation in the intensive care unit: a concept analysis. Journal of Advanced Nursing. https://doi.org/https://doi.org/10.1111/jan.17000
Adams AMN, Chamberlain D, Maiden MJ, Thorup CB, Nørgaard MW, Laugesen B, Grønkjær M, Bruce K, Waite C, Lamprecht C, Conroy T. Clinical Practice Guideline for Non-pharmacological Prevention and Management of Patient Agitation in the Adult Intensive Care Unit (CALM ICU). Accepted by Australian Critical Care, Oct 2025
Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci. 2015;11(1):1-13.
Rubin R. It takes an average of 17 years for evidence to change practice - the burgeoning field of implementation science seeks to speed things up. Jama. 2023;329(16):1333-6.
Sigma Membership
Phi Gamma (Virtual)
Type
Poster
Format Type
Text-based Document
Study Design/Type
Exploratory Sequential Design
Research Approach
Mixed/Multi Method Research
Keywords:
Implementation Science, Acute Care, Interprofessional, Interdisciplinary, Practice Guidelines, Agitation Prevention and Control, Intensive Care Units, CALM ICU Guidelines
Recommended Citation
Adams, Anne Mette Noerby; Dafny, Hila; de Plaza, Maria Alejandra Pinero; McIntyre, JoAnne; Jin, Xia; Bihari, Shailesh; Bruce, Kay; Waite, Cherie; Block, Heather; De Lyster, Kathrine; and Lin, Frances Fengzhi, "Current ICU Practices and Barriers to CALM ICU Guideline Uptake" (2026). International Nursing Research Congress (INRC). 26.
https://www.sigmarepository.org/inrc/2026/posters_2026/26
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-25
Funder
Flinders Foundation
Current ICU Practices and Barriers to CALM ICU Guideline Uptake
Toronto, Ontario, Canada
Background: Agitation in the intensive care unit (ICU) can compromise patient safety, prolong recovery, and contribute to staff injuries. While pharmacological interventions are sometimes necessary, they carry risks such as oversedation, delirium, and prolonged mechanical ventilation. The CALM ICU guideline provides recommendations for the non-pharmacological prevention and management of patient agitation. However, guidance on how to implement these strategies in complex ICU environments remains limited.
Aim: To explore current ICU practices and stakeholder perspectives on the barriers and facilitators to implementing non-pharmacological strategies for managing agitation.
Methods: This mixed-methods study used an exploratory sequential design guided by the i-PARIHS framework. Conducted in a 32-bed tertiary ICU in Australia, data collection included a cross-sectional survey, focus groups with ICU clinicians and semi-structured interviews with former patients and family members. The survey explored current practices, use of non-pharmacological strategies, clinicians’ knowledge and attitudes, and perceived barriers and facilitators to guideline uptake. Interviews explored experiences of agitation management, involvement in care, communication, and support needs. Quantitative data were analysed descriptively and with appropriate statistical tests, while qualitative data were analysed thematically guided by the i-PARIHS constructs.
Results: Data analysis is currently underway, with results expected by April 2026. Findings from this study will directly inform a co-design study, in which interdisciplinary clinicians, patients, and family representatives will collaboratively develop a tailored implementation framework for the CALM ICU guideline.
Conclusion: This study provides a foundation for improving the management of patient agitation in the ICU by identifying practice gaps and stakeholder perspectives. Using a structured knowledge translation approach, it aims to support the uptake of the CALM ICU guidelines and promote sustainable practice change. The findings may also inform broader efforts to adapt and implement the guidelines across diverse ICU settings, nationally and internationally.
Description
Guided by the i-PARIHS framework, this mixed-methods study explores how patient agitation is currently managed in the ICU, along with barriers and facilitators to implementing the CALM ICU guidelines. Results, expected by April 2026, will inform a co-design phase where stakeholders collaboratively develop a tailored implementation framework.