Quality Improvement Initiative Using Blended In Situ Simulation Training on Procedural Sedation and Analgesia in a Pediatric Emergency Department

Nucci, Alessia; Sforzi, Idanna; Morley-Fletcher, Alessio; Saffirio, Claudia; Bussolin, Leonardo; Masi, Stefano; Weinstock, Peter; Luca, Marco De

doi:10.1097/sih.0000000000000626

Cited by 8 publications

(1 citation statement)

References 40 publications

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“…Simulation-based training has been shown to improve crisis resource management and compliance with safety standards during paediatric procedural sedation [29,30]. The implementation of dedicated sedation teams is reasonable when aiming at achieving optimal qualification of the sedation personnel and performing most efficient sedations.…”

Section: Qualification Of Sedation Teamsmentioning

confidence: 99%

Safety and quality in paediatric procedural sedation: what really matters?

Röher

Becke‐Jakob

Eich

2023

Current Opinion in Anaesthesiology

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Purpose of reviewThis review gives an overview of the safety aspects for paediatric procedural sedation and a discussion of possibilities for optimizing structure, processes and outcomes.Recent findingsProcedural sedation in paediatric patients is performed by providers of different specialties and compliance with safety standards is a basic requirement regardless of provider specialty. This includes preprocedural evaluation, monitoring, equipment and profound expertise of sedation teams. The choice of sedative medications and the possibility of incorporating nonpharmacological methods play an important role for optimal outcome. In addition, an ideal outcome from the patient's perspective includes optimized processes and clear and empathetic communication.SummaryInstitutions providing paediatric procedural sedation must ensure the comprehensive training of sedations teams. Furthermore, institutional standards for equipment, processes and optimal choice of medication depending on performed procedure and comorbidities of the patient must be established. At the same time, organizational and communication aspects should be considered.

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Section: Qualification Of Sedation Teamsmentioning

confidence: 99%

Safety and quality in paediatric procedural sedation: what really matters?

Röher

Becke‐Jakob

Eich

2023

Current Opinion in Anaesthesiology

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Midazolam premedication in ileocolic intussusception: a retrospective multicenter study

et al. 2022

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Procedural sedation and analgesia in Swiss Pediatric Emergency Departments: a national subgroup analysis of a European cross-sectional survey

Romano,

Brändle,

Abplanalp-Marti

et al. 2024

Eur J Pediatr

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This study aims to provide a national overview of procedural sedation and analgesia practices within Pediatric Emergency Departments in Switzerland, focusing on the availability of pharmacologic agents, the presence of safety protocols, the utilization of non-pharmacological interventions, and to identify specific local limitations. We conducted a detailed subgroup analysis of Swiss data from a European cross-sectional survey on emergency department pediatric Procedural Sedation and Analgesia (PSA) practice, isolating data from Swiss sites. The survey, conducted between November 2019 and March 2020, covered various aspects of procedural sedation and analgesia practices. The survey included nine Swiss sites, treating a total of 252,786 patients in 2019. Topical analgesia, inhaled equimolar nitrous oxide-oxygen mixture, and ketamine were largely available. All sites had nurse-directed triage protocols in place; however, opioid administration was included in the protocols in only 66% of sites. Only 33% of hospitals reported common use of intravenous sedation. Barriers to procedural sedation and analgesia implementation included staffing shortages (89% of sites) and lack of dedicated spaces (78%).Conclusions: Despite a broad array of pharmacological and options available in Swiss Pediatric Emergency Departments, challenges remain in standardizing practices across the country. Limited space and staffing and enhancing training on non-pharmacological interventions were identified as potential areas for improving pain and anxiety management in pediatric emergency care. This study underscores the need for national guidelines to harmonize emergency department PSA practices across Switzerland, ensuring all children have access to effective and evidence-based procedural comfort. What is Known:• Recent research, conducted in European emergency departments, suggests that in pediatric Procedural Sedation and Analgesia (PSA) resources are limited, and practice is heterogeneous What is New:• Swiss pediatric hospitals offer a wide range of pharmacological options for pain and anxiety management. However, significant barriers to PSA were identified. These include external control of intravenous sedation and insufficient integration of non-pharmacological interventions, such as child life specialists and procedural hypnosis. National guidelines are needed to harmonize PSA practices

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Quality Improvement Initiative Using Blended In Situ Simulation Training on Procedural Sedation and Analgesia in a Pediatric Emergency Department

Cited by 8 publications

References 40 publications

Safety and quality in paediatric procedural sedation: what really matters?

Safety and quality in paediatric procedural sedation: what really matters?

Midazolam premedication in ileocolic intussusception: a retrospective multicenter study

Procedural sedation and analgesia in Swiss Pediatric Emergency Departments: a national subgroup analysis of a European cross-sectional survey

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