The impact of introducing nurse-led analgesia and sedation guidelines in ventilated infants following cardiac surgery
Autor: | Monique van Dijk, Seamus Cowman, Abraham J. Valkenburg, Ricardo Segurado, Brendan O'Hare, Claire Magner, Dermot R. Doherty |
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Přispěvatelé: | Intensive Care, Internal Medicine, Pediatric Surgery |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty PICU Quality-improvement Sedation medicine.medical_treatment Population Pain Guideline Intensive Care Units Pediatric Critical Care Nursing Nurse's Role 03 medical and health sciences 0302 clinical medicine medicine Humans Pain Management Ventilated Cardiac Surgical Procedures Child education Retrospective Studies Pediatric Mechanical ventilation Pain Postoperative education.field_of_study 030504 nursing business.industry Infant 030208 emergency & critical care medicine medicine.disease Respiration Artificial Cardiac surgery Distress Cardiothoracic surgery Child Preschool Emergency medicine Female Analgesia Deep Sedation medicine.symptom 0305 other medical science Trisomy business |
Zdroj: | Intensive and Critical Care Nursing, 60:102879. Churchill Livingstone |
ISSN: | 1532-4036 0964-3397 |
Popis: | Introduction: Enhanced clinical outcomes in the Paediatric Intensive Care Unit following standardisation of analgesia and sedation practice are reported. Little is known about the impact of standardisation of analgesia and sedation practice including incorporation of a validated distress assessment instrument on infants post cardiac surgery, a subset of whom have Trisomy 21. This study investigated whether the parallel introduction of nurse-led analgesia and sedation guidelines including regular distress assessment would impact on morphine administered to infants post cardiac surgery, and whether any differences observed would be amplified within the Trisomy 21 population. Methodology: A retrospective single centre before/after study design was used. Patients aged between 44 weeks postconceptual age and one year old who had open cardiothoracic surgery were included. Results: 61 patients before and 64 patients after the intervention were included. After the intervention, a reduction in the amount of morphine administered was not evident, while greater use of adjuvant sedatives and analgesics was observed. Patients with Trisomy 21 had a shorter duration of mechanical ventilation after the change in practice. Conclusion: The findings from this study affirm the importance of the nurses’ role in managing prescribed analgesia and sedation supported by best available evidence. A continued education and awareness focus on analgesia and sedation management in the pursuit of best patient care is imperative. National Children's Research Centre |
Databáze: | OpenAIRE |
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