Improving Outcomes in Pediatric Procedural Sedation
Abstract:Background: In Fall 2003, Chris Evert Children's Hospital (CECH; Fort Lauderdale, Florida) exclusively used chloral hydrate for moderate sedation. As procedures became longer and more complex, pentobarbital became the primary sedative used. Yet children receiving pentobarbital were awakening during the procedure from paradoxical drug reactions or insufficient sedation. In 2003, the failed sedation rate was 12.29%—more than six times the national benchmark of 2%.
Methods: The pediatric sedation team created a pediatric sedation protocol, which reflected the designation of an a2-adrenergic agonist, dexmedetomidine (dex), as the drug of choice and spearheaded a variety of performance improvement changes, including creation of a stand-alone eight-bed sedation unit to accommodate the registration process and pre-assessment and postprocedure monitoring and to include the parent in the treatment continuum.
Results: Following the implementation of the new protocol in 2003, the failed sedation rate for children undergoing various diagnostic and therapeutic procedures decreased from 12.29% to 1.63% in 2004, 0.19% in 2005, and 0.28% in 2006; in 2007 the rate was 0.72%—reflecting an average 98% reduction in the failed sedation rate.
Discussion: The continued improvement and success in pediatric sedation over time indicates that the protocol has sustained benefits and lasting value.
Document Type: Research Article
Publication date: 2008-04-01
More about this publication?
- The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
- Editorial Board
- Information for Authors
- Subscribe to this Title
- Information for Advertisers
- Reprints and Permissions
- Ingenta Connect is not responsible for the content or availability of external websites