Decreasing Parental Worry Prior to Sedation Induction: A QI Project in the Day Medicine Unit of Nemours AI duPont Hospital for Children
By Sarah L. Dal Porto, BSN, RN and Tracy Campbell, MSN, APRN, PCNS-BC, CCRN
The Day Medicine Unit of the Nemours AI duPont Hospital for Children is a multifaceted department providing outpatient infusion therapy and sedation services for all therapeutic and diagnostic procedures completed outside of the operating room. Our current model utilizes credentialed sedation physicians, anesthesiologists, CRNA’s, advanced practice nurses and staff nurses to provide care for a variety of specialties for inpatient and outpatient areas.
Reducing parental worry can improve outcomes for children following sedated procedures and is associated with increased satisfaction scores for families as a whole. A literature review supports providing parents/caregivers with accurate and concise information about the induction of sedation to relieve worry.
An educational opportunity was identified in our sedation process regarding the delivery of information to parents about sedation induction. Inconsistencies with information content and delivery methods were identified.
After a review of the literature, an evidence-based quality improvement project was initiated. A standardized script was developed focusing on providing concise information in non-threatening language for patients and caregivers. The script focused on the sedation induction process, and the use of simple, non-threatening words was of major importance to our process. Parents were given a family education sheet to review upon arrival to our department.
Seven core nurses were trained in the use of the standardized script to deliver sedation induction information to parents prior to sedation induction. Participating staff nurses completed a survey to assess the usefulness of the script and the impact on parental worry before, during and after sedation induction.
Survey results were analyzed for trends concerning the effectiveness of standardized scripting and sedation induction workflow. Data supported the effectiveness of the scripting tool and proved beneficial for parents. Our patient satisfaction scores for explanation of procedure and concern for parental worry were also followed and increased after implementation of the scripting.
The standardized script was adopted into our sedation practice and is currently being utilized by all staff RN’s.
Future projects include adapting the family education sheet into Spanish and advancing our quality improvement project into a research study involving the parent perspectives on worry.