Clinical pathway development to standardize pharmacological medication management of agitation in pediatric inpatient settings.

IF 2.9 Q2 PSYCHIATRY
Michael D Wood, Kavi Gandhi, Dean Elbe, Kelly Saran, Sarah Leung, Joanna McKay, Roxane Carr, Andrea Chapman
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引用次数: 0

Abstract

Objective: Acute agitation in pediatrics is commonly encountered in hospital settings, can contribute to significant physical and psychological distress, and management is highly varied in practice. As such, the development of a standardized pharmacologic guideline is paramount. We aimed to develop a novel clinical pathway (CP) for management of acute agitation for all hospitalized pediatric patients in Canada.

Methods: Healthcare professionals in Canada with expertise in treating and managing pediatric agitation formed a working group and developed a CP through conducting a literature review, engaging key partners, and obtaining interdisciplinary consensus (iterative real-time discussions with content experts). Once developed, the preliminary CP was presented to additional internal and external partners via multiple grand rounds and a webinar; feedback from participants guided final CP revisions.

Results: The working group created a pediatric inpatient CP to guide pharmacologic management of agitation and serve as an easy-to-use clinical and educational resource with three complementary sections including: 1) a treatment algorithm, 2) a quick reference medication chart, and 3) two supporting documents, which provide a general overview of non-pharmacologic strategies prior to CP implementation and an illustrative scenario to accompany the medication chart to ensure effective utilization.

Conclusions: This is the first CP to standardize pharmacological treatment and management of acute agitation in children in inpatient settings in Canada. Although further research is warranted to assess implementation and support process improvement, the CP can be adapted by individual institutions to assist in prompt pharmacological management of pediatric agitation to potentially improve outcomes for patients, families, and healthcare professionals.

制定临床路径,规范儿科住院病人躁动症的药物治疗。
目的:儿科急性躁动症在医院环境中很常见,可导致严重的身心痛苦,而且在实践中处理方法千差万别。因此,制定标准化的药物治疗指南至关重要。我们的目标是为加拿大所有住院儿科患者的急性躁动管理制定一个新的临床路径(CP)。方法:加拿大在治疗和管理儿科躁动方面具有专长的医护人员组成了一个工作组,并通过进行文献综述、吸引主要合作伙伴参与以及获得跨学科共识(与内容专家进行迭代式实时讨论)来制定 CP。初步方案制定后,通过多次大查房和网络研讨会向更多的内部和外部合作伙伴进行了介绍;与会者的反馈意见指导了方案的最终修订:工作组创建了儿科住院病人 CP,用于指导躁动的药物治疗,并作为易于使用的临床和教育资源,包括三个互补部分:1) 治疗算法;2) 快速参考用药表;3) 两份辅助文件,其中包括在实施 CP 之前对非药物治疗策略的概述,以及与用药表配套的示例情景,以确保有效利用:这是加拿大首个对住院环境中儿童急性躁动的药物治疗和管理进行标准化的 CP。虽然还需要进一步的研究来评估实施情况并支持流程改进,但各医疗机构可对该 CP 进行调整,以协助对儿科躁动进行及时的药物治疗,从而改善患者、家属和医护人员的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
4.30%
发文量
35
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