Summary

Impact of a quality of care improvement team on the use of sedatives during wound repair in young children

González Balenciaga M, Ballestero Y, Udaondo J, García S, Mintegi S, Benito J

Affiliation of the authors

Servicio Urgencias Pediatría, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain. Servicio Pediatría, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.

DOI

Quote

González Balenciaga M, Ballestero Y, Udaondo J, García S, Mintegi S, Benito J. Impact of a quality of care improvement team on the use of sedatives during wound repair in young children. Emergencias. 2016;28:375-80

Summary

Objective.

To analyze the impact of actions organized by a quality of care improvement team on the use of sedatives when treating wounds in children under the age of 5 years.

Methods.

Quasiexperimental pre/post study enrolling children under the age of 5 years brought to a pediatric emergency department with wounds requiring surgical repair with suturing. A team to promote the use of sedation in such minor procedures in these children was established. The team organized the following interventions: training

workshops, development and circulation of a sedation protocol, and establishment of a computerized alert. The first analysis of results was done at 2 months and the second at 9 months. The quality of care indicators, the use of sedatives while wounds were treated in children, was analized in 2 age groups: (under the age of 2 years and between 2 and 5 years) and results were compared with the preintervention phase.

Results.

A total of 22 958 emergencies were registered in children under 5 years old; 548 (2.4%) involved uncomplicated wounds. Of the 548 patients, 350 (63.8%) required surgical repair, 75 of them (21.4%) in children under the age of 2 years. Ten percent of these children had received a sedative in the period before the team’s intervention;

22% had been sedated at the 2-month analysis and 31.4% at 9 months (P<.01). For children between 2 and 5 years old, the percentages were 4.4% (pre-intervention), 10% (2 months), and 25% (9 months) (P<.01). Eighty-two percent of the families and 69% of the physicians thought that anxiety was adequately controlled. Conclusion. Actions designed by a multidisciplinary quality of care team are effective for increasing the use of sedatives while wounds are treated in children under the age of 5 years.

 

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