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Documentation of Assessments and Interventions Using a Pediatric Preoperative Risk Assessment Checklist in the
Myrna E Mamaril1, Ryan MacDonald2
1Perioperative Services, Johns Hopkins Hospital, Baltimore, MD.
Insights
Implementing a pediatric preoperative risk assessment (PPRA) checklist increased postanesthesia care unit (PACU) nursing assessments and interventions for children at risk of respiratory complications. This proactive approach helps prevent adverse events during emergence from anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Nursing
- Patient Safety
Background:
- Respiratory complications during emergence from anesthesia are a significant concern in pediatric patients.
- Effective risk assessment is crucial for identifying children at higher risk.
- Standardized tools can enhance the consistency and quality of care.
Purpose of the Study:
- To evaluate the impact of an evidence-based pediatric preoperative risk assessment (PPRA) checklist.
- To determine the effect on the frequency of postanesthesia care unit (PACU) nursing assessments and interventions.
- To assess the management of children at risk for respiratory complications during anesthetic emergence.
Main Methods:
- A prospective pre-/post-intervention study design was employed.
- Pediatric perianesthesia nurses assessed 100 children pre-intervention and 100 post-intervention using the PPRA checklist.
- Nurses received education on pediatric preoperative risk factors (PPRF) before the post-intervention phase.
Main Results:
- A statistically significant increase (P < .001) in PACU nursing assessments and interventions was observed post-intervention.
- The frequency of assessments/interventions correlated positively with the number and weight of identified risk factors.
- The PPRA checklist facilitated more frequent and targeted nursing care.
Conclusions:
- The PPRA checklist enables PACU nurses to identify total pediatric preoperative risk factors (PPRFs).
- Nurses utilized the checklist to increase assessments and implement preemptive interventions.
- This strategy aims to prevent or mitigate respiratory complications in high-risk pediatric patients during anesthetic emergence.
Purpose:
Describe the impact of the implementation of an evidence-based pediatric preoperative risk assessment (PPRA) checklist on the frequency of postanesthesia care unit (PACU) nursing assessments and interventions in children at risk for respiratory complications during emergence from anesthesia.
Design:
Prospective pre-/postdesign.
Methods:
Pediatric perianesthesia nurses assessed 100 children preintervention according to current standard. After nurses received pediatric preoperative risk factor (PPRF) education, another 100 children were assessed postintervention using the PPRA checklist. Pre-/postpatients were unmatched for statistical purposes due to two different groups. Frequency of PACU nursing respiratory assessments/interventions was evaluated.
Findings:
Demographic variables, risk factors, frequency of nursing assessments/interventions were summarized in pre-/postinterventions. Significant differences (P < .001) were noted between pre-/postintervention groups with increased frequency of postnursing assessments/interventions that correlated with increased risk factors and weighted risk factors.
Conclusions:
By identifying total PPRFs, PACU nurses used their plan of care to frequently assess and pre-emptively intervene with children who had increased risk factors to prevent or mitigate respiratory complications on emergence from anesthesia.
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