Evidence map›Paper›PMID 34980589›Full record

ArticleBMJ open quality2022

Implementation of a sedation protocol: a quality improvement project to enhance sedation management in the paediatric intensive care unit.

Tarek Hazwani, Arwa Al Ahmady, Yasser Kazzaz, Abeer Al Smari, Seham Al Enizy, Hamza Alali

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Tarek HazwaniDepartment of Pediatrics, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia tarekhazwani@gmail.com.ORCID 0000-0001-5343-7263
Arwa Al AhmadyNursing Service, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Yasser KazzazDepartment of Pediatrics, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.ORCID 0000-0003-3590-4547
Abeer Al SmariCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Seham Al EnizyNursing Service, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Hamza AlaliDepartment of Pediatrics, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
King Saud bin Abdulaziz University for Health Sciences · SANational Guard Health Affairs · SAKing Abdullah International Medical Research Center · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProper sedation is integral to ensuring the safety and comfort of children on mechanical ventilation (MV). Sedation protocols help to achieve this goal and reduce the duration of MV. We have observed varied sedation approaches, sedation score targets and sedative use by our physicians, which were manifested as oversedation and undersedation with associated accidental extubation. Hence, we aimed to implement a standardised sedation protocol and assess its impact on mechanically ventilated paediatric patients.

methodsA multidisciplinary quality improvement team was formed to develop and implement a standardised sedation protocol for mechanically ventilated paediatric patients. COMFORT-Behaviour (COMFORT-B) Scale score was used to assess the sedation targets and define undersedation, oversedation or adequate sedation. Our goal was to achieve adequate sedation during 90% of the sedation period. Based on the model for improvement methodology, we used plan-do-study-act cycles to develop, test and implement the new sedation protocol.

resultsThere was an immediate percentage increase in COMFORT-B Scale scores within the target sedation level, which was associated with a gradual decrease in the need for intermittent sedation doses over sedation infusion in the preimplementation, improvement and control phases (6.3, 4.9 and 3.1 sedation doses/12 hours/patient, respectively) to achieve adequate sedation target.

conclusionsThe standardisation of sedation protocols was safe and efficient, and improved the sedation quality in mechanically ventilated paediatric patients.

Indexed as

Procedural SedationQuality ImprovementChildHumansHypnotics and SedativesIntensive Care Units, PediatricRespiration, ArtificialHypnotics and Sedativescritical carepaediatricspatient safety

Identifiers

PMID34980589
PMCPMC8724811
OpenAlexW4206603617

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.