Evaluating the Safety of a Ketamine Sedation Protocol In a Pediatric Oncology Population in Tanzania: A Quality Improvement Project.

This project aimed to reintroduce and evaluate a pediatric ketamine sedation protocol at a Zonal Referral Center in Mwanza, Tanzania, where nonanesthesia clinicians provide sedation when trained anesthesia personnel are unavailable. The objectives were to assess knowledge retention, confidence, and protocol compliance. The study design used a pre- and postintervention design. Nonanesthesia clinicians at a > 1,000-bed hospital were surveyed to assess their knowledge and confidence about ketamine sedation. Over 10 days, 50 clinicians received training that included lectures and cognitive aid resources in English and Swahili (the local language). Knowledge and confidence were measured using paired surveys. Clinicians were observed for compliance, skill demonstration, and feedback during postimplementation sedation encounters. Results showed significant improvements in knowledge (M = 6.93-8.77; P = .001) and confidence (M = 5.94-8.98; P = .001). Seven sedation encounters were observed over a 7-day period, and compliance with the presedation assessment was 100% for last food or drink intake, allergy history, and medication history. Reintroducing this protocol in a low-resource setting led to improvements in knowledge, confidence, and skills among nonanesthesia clinicians.