Paediatric anaesthesia · 2025
Benefit of an Interdisciplinary Pediatric Sedation Team With a Clinical Pharmacist on Outpatient Appointment Duration and Procedural Sedation Time.
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Pero-Cleveland Emersen, Rabey Jonathan, Mosher Allen, Geraci Emily, DePaul Shaina, Hutchinson David, Natoli Jennifer L, van der Jagt Elise, Acquisto Nicole M
Аннотация
BACKGROUND: There is difficulty completing outpatient procedures in children with complex developmental and behavioral diagnoses. These visits may require increased personnel and incur delays.
AIMS: We sought to evaluate if an interdisciplinary team of providers, nurses, and a clinical pharmacist dedicated to advanced preparation (e.g., discussing patient, reviewing concerns with procedure completion, understanding medication needs) and the development of a pre-appointment plan can streamline outpatient visits.
METHODS: Pediatric patients with complex behavioral disorders requiring a procedure at an outpatient visit were evaluated retrospectively using pre- and post-implementation data. Outcomes assessed were duration of outpatient appointment and procedural sedation times, procedure success, and description of pharmacist interventions as part of the team. Data are reported descriptively.
RESULTS: Thirty-five patients were included: 17 pre- and 18 post-implementation of the team. Median appointment and sedation times were reduced in the post- compared to the pre-implementation group, 133 min (IQR 98-178) vs. 173 min (IQR 153-190) (p = 0.08) and 40 min (IQR 30-54) vs. 75 min (IQR 45-100) (p = 0.02), respectively. There was no difference in procedure success, and 15 pharmacist interventions were made in six patients in the post-implementation group related to drug-drug interactions, premedication selection, and dose recommendations.
CONCLUSIONS: An interdisciplinary sedation team focused on pre-appointment planning for complex pediatric behavioral patients requiring a procedure in the outpatient setting was associated with reduced appointment and sedation times, a clinically and statistically significant finding, respectively. Future studies should focus on resource utilization and patient and caregiver satisfaction.
AIMS: We sought to evaluate if an interdisciplinary team of providers, nurses, and a clinical pharmacist dedicated to advanced preparation (e.g., discussing patient, reviewing concerns with procedure completion, understanding medication needs) and the development of a pre-appointment plan can streamline outpatient visits.
METHODS: Pediatric patients with complex behavioral disorders requiring a procedure at an outpatient visit were evaluated retrospectively using pre- and post-implementation data. Outcomes assessed were duration of outpatient appointment and procedural sedation times, procedure success, and description of pharmacist interventions as part of the team. Data are reported descriptively.
RESULTS: Thirty-five patients were included: 17 pre- and 18 post-implementation of the team. Median appointment and sedation times were reduced in the post- compared to the pre-implementation group, 133 min (IQR 98-178) vs. 173 min (IQR 153-190) (p = 0.08) and 40 min (IQR 30-54) vs. 75 min (IQR 45-100) (p = 0.02), respectively. There was no difference in procedure success, and 15 pharmacist interventions were made in six patients in the post-implementation group related to drug-drug interactions, premedication selection, and dose recommendations.
CONCLUSIONS: An interdisciplinary sedation team focused on pre-appointment planning for complex pediatric behavioral patients requiring a procedure in the outpatient setting was associated with reduced appointment and sedation times, a clinically and statistically significant finding, respectively. Future studies should focus on resource utilization and patient and caregiver satisfaction.