RESUMEN
The Pasero Opioid-induced Sedation Scale (POSS) is a valid, reliable tool used to assess sedation when administering opioid medications to manage pain. The POSS is endorsed by The Joint Commission and the American Society for Pain Management Nursing to help prevent adverse opioid-related respiratory events. Although the POSS is used to assess sedation in pediatric patients at some hospitals, prior to this study, it was not formally evaluated in the pediatric population. This study used a quasi-experimental design with a convenience sample of pediatric patients admitted to a large regional medical center in southeastern North Carolina. The POSS was evaluated from three perspectives. First, the study was designed to compare the documentation of sedation when opioids were administered before (n=25) and after (n=27) implementation of the POSS to assess sedation. Second, the occurrence of respiratory adverse events before and after implementation of the POSS was compared. Third, the appropriateness of using the POSS in the pediatric population was evaluated. When the POSS was used, there was an increase in both the clarity and frequency of documentation when sedation was assessed. There was no incidence of opioid-related adverse respiratory events after implementation of the POSS. Finally, the POSS was found to be appropriate and safe to use in the pediatric population. Through a survey, the majority of registered nurses who cared for the research subjects evaluated the POSS as easy, appropriate and safe to use with pediatric patients. The nurses also noted using the POSS provided standardized communication among staff regarding patients' levels of sedation. No adverse effects, concerns, or objections were reported. Coincidentally, while it was not part of the study, frequency of documentation of assessment of pain also improved with implementation of the POSS.
Asunto(s)
Analgésicos Opioides/administración & dosificación , Periodo de Recuperación de la Anestesia , Sedación Consciente/métodos , Manejo del Dolor/métodos , Insuficiencia Respiratoria/inducido químicamente , Adolescente , Factores de Edad , Analgésicos Opioides/efectos adversos , Distribución de Chi-Cuadrado , Niño , Preescolar , Estudios de Cohortes , Sedación Consciente/efectos adversos , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Manejo del Dolor/efectos adversos , Insuficiencia Respiratoria/prevención & control , Estudios Retrospectivos , Medición de Riesgo , Poblaciones VulnerablesRESUMEN
Time and space must take on a new dimension for nursing care as health systems evolve into expanded networks.
