Loading...
Please wait, while we are loading the content...
Similar Documents
The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis
| Content Provider | Scilit |
|---|---|
| Author | Cloedt, Lise D. Benbouzid, Kenza Lavoie, Annie Metras, Marie-Élaine Lavoie, Marie-Christine Harakat, Samira Harrington, Karen Ducharme-Crevier, Laurence |
| Copyright Year | 2021 |
| Description | Delirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1723037.pdf |
| Ending Page | 239 |
| Page Count | 7 |
| Starting Page | 233 |
| ISSN | 21464618 |
| DOI | 10.1055/s-0041-1723037 |
| Journal | Journal of Pediatric Intensive Care |
| Issue Number | 03 |
| Volume Number | 11 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2021-02-11 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Pediatric Intensive Care Critical Care Medicine Pediatric Intensive Care Units |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health |
