The impact of introducing nurse-led analgesia and sedation guidelines in ventilated infants following cardiac surgery

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Title: The impact of introducing nurse-led analgesia and sedation guidelines in ventilated infants following cardiac surgery
Authors: Magner, ClaireValkenburg, Abraham J.Doherty, DermotSegurado, Ricardoet al.
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Date: Oct-2020
Online since: 2021-03-08T12:25:30Z
Abstract: 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.
Funding Details: National Children's Research Centre
Type of material: Journal Article
Publisher: Elsevier
Journal: Intensive and Critical Care Nursing
Volume: 60
Copyright (published version): 2020 Elsevier
Keywords: AnalgesiaGuidelineInfantPainSedationPediatricPICUQuality-improvementVentilated
DOI: 10.1016/j.iccn.2020.102879
Language: en
Status of Item: Peer reviewed
ISSN: 0964-3397
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Appears in Collections:Nursing, Midwifery & Health Systems Research Collection
Public Health, Physiotherapy and Sports Science Research Collection

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