Satisfaction of nurses with the Withdrawal Assessment Tool-1 (WAT-1)

Use of opioids and benzodiazepines in critically ill children results in an increased risk of withdrawal syndrome requiring the pediatric nurse to accurately assess the patient's clinical state. A valid and reliable pediatric withdrawal assessment tool could be of considerable value to improve nursing care.

To evaluate nurses' satisfaction with a new pediatric assessment tool, the Withdrawal Assessment Tool-1 (WAT-1).

Forty-one Pediatric Intensive Care Unit (PICU) and 27 Pediatric Intermediate Care Unit (PIMC) staff participated in a pre- and post-implementation survey. The survey looked at confidence in assessment skills, perception of communication about withdrawal, and satisfaction with nursing care of the child undergoing withdrawal syndrome. Staff were surveyed, completed online education about the WAT-1, and then repeated the survey after six months of clinical use.

Overall confidence in assessment changed very little. There was improvement in the perception of communication (p = 0.005) as well as satisfaction with care provided (p = 0.00002) after implementation of the WAT-1. In particular, satisfaction with nursing documentation of withdrawal syndrome improved significantly (p = 0.00002).

The WAT-1 improves nurses' satisfaction with their care of children undergoing withdrawal syndrome, in particular, their documentation of the level of withdrawal symptoms.