{"id":271,"date":"2024-11-05T21:11:56","date_gmt":"2024-11-05T21:11:56","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?page_id=271"},"modified":"2024-11-05T21:11:56","modified_gmt":"2024-11-05T21:11:56","slug":"using-quality-transformation-to-increase-outpatient-sedation-success","status":"publish","type":"page","link":"https:\/\/iims.uthscsa.edu\/isrn\/resources\/ereading-room\/abstracts\/using-quality-transformation-to-increase-outpatient-sedation-success\/","title":{"rendered":"Using Quality Transformation to Increase Outpatient Sedation Success"},"content":{"rendered":"

[vc_row][vc_column width=”2\/3″][vc_column_text css=””]<\/p>\n\n\n\n\n\n
Primary Author:<\/td>\nJoy Hesselgrave, MSN, RN, CPON<\/td>\n<\/tr>\n
Co-Principal Investigators\/Collaborators:<\/td>\nM. Brooke Bernhardt, Marla Daves, Kala Kamdar, Kathy McCarthy, Marilyn J. Hockenberry<\/td>\n<\/tr>\n
Organization:<\/td>\nTexas Children\u2019s Hospital<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Abstract<\/h2>\n

Background<\/h3>\n

A review of current clinic procedural sedation practices revealed that dosages for sedation agents were below recommended amounts found in the literature. As part of the Quality Transformation (QT) Core within our Cancer Center, an evidence-based (EB) procedural sedation guideline was developed to improve care for children who experience painful procedures as part of cancer treatment.<\/p>\n

Purpose<\/h3>\n

The goal of this interdisciplinary QT project was to increase the number of patients achieving adequate sedation by implementing the EB guideline for 100% of the patients undergoing clinic procedures under moderate sedation. Key drivers for success included educating and engaging faculty and staff about the EB guideline and sedation order changes.<\/p>\n

Methods<\/h3>\n

QT outcome measures evaluated satisfaction with sedation and a score of the child\u2019s level of sedation as perceived by parents, providers, and nurses. To ensure that the sedation drug dosing was safe, the number of reversal agents used before and after implementation of the EB guideline was monitored. The total time sedated as well as total monitoring time in the clinic was assessed to ensure increased sedation dosing did not negatively impact clinic patient flow.<\/p>\n

Results<\/h3>\n

Quality metrics were evaluated in 35 children over a two-week period and compared with data collected on 30 children prior to implementation of the EB guideline. There was an increase in the target level of sedation (\u201csleeping comfortably or awake but relaxed and cooperative\u201d) after EB guideline implementation. There was a reduction in patients who were \u201cawake and crying or moving\u201d as reported by respondents. There was no significant increase in the number of reversal agents used, time sedated, or time monitored.<\/p>\n

Conclusion<\/h3>\n

This QT project demonstrates that interdisciplinary collaboration improves EB guideline implementation success and can greatly impact procedure sedation success for children with cancer.<\/p>\n

\u00a9 Improvement Science Research Network, 2011[\/vc_column_text][\/vc_column][vc_column width=”1\/3″]