ABSTRACT
The quality assurance and improvement committee on a general pediatric unit identified a problem with sedation for neuroradiologic studies. Twenty-three percent of children (n = 63) failed to sedate with one dose of chloral hydrate, resulting in delays or cancellations. For children receiving a second dose of chloral hydrate, average time to study completion was 97 minutes, and 70 percent of the children (n = 10) were successfully sedated. A protocol was developed for the use of intranasal midazolam as the follow-up agent. Evaluation on a pilot unit revealed that the average time to test completion decreased to 55 minutes and that the success rate was 82 percent (n = 11). The nursing staff prefer the use of intranasal midazolam as the follow-up agent because of its quicker sedation and decreased duration of action.
Subject(s)
Chloral Hydrate/therapeutic use , Hypnotics and Sedatives/therapeutic use , Midazolam/administration & dosage , Administration, Intranasal , Child, Preschool , Conscious Sedation , Drug Therapy, Combination , Hospitalization , Humans , Hypnotics and Sedatives/administration & dosage , Infant , Magnetic Resonance Imaging , Nursing Care , Pilot Projects , Quality of Health Care , Tomography, X-Ray ComputedABSTRACT
Successful implementation of Agency for Health Care Policy and Research (AHCPR) clinical practice guidelines must involve an institutional commitment and an interdisciplinary effort. This article describes how a pediatric nursing research committee took the leadership role in implementing the AHCPR acute pain guidelines for children. Steps toward implementation included assessment of current practice methods, nursing interventions, interdisciplinary interventions, and plans for evaluating the practice change through the institutional quality assessment and improvement program.
Subject(s)
Nursing Service, Hospital/standards , Pain/nursing , Pediatrics/standards , Practice Guidelines as Topic , Acute Disease , Child , Family , Humans , Inservice Training , Patient Care Team/organization & administration , Patient Education as Topic , Program Development , United States , United States Agency for Healthcare Research and QualitySubject(s)
Child Care/standards , Pain/drug therapy , Pain/nursing , Adolescent , Analgesics, Opioid/therapeutic use , Child , Child, Preschool , Denial, Psychological , Female , Humans , Infant , Male , Pain/psychology , Pain Measurement , Pain, Postoperative/drug therapy , Pain, Postoperative/nursing , Parents , Practice Guidelines as Topic , Psychology, Child , United States , United States Agency for Healthcare Research and QualityABSTRACT
Toy latex balloons are one of the leading causes of pediatric choking deaths from children's products. Education programs through community outreach are an effective way to alert professionals and parents about the risks associated with the use of latex balloons. Nurses, in a collective action, can play a major role in educating the public on balloon safety awareness.
