MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units
Background: Analgosedation (AS) assessment using clinical scales is crucial to follow the international recommendations about analgosedation. The Analgosedation workgroup of the Spanish Society of Pediatric Intensive Care (SECIP) carried out two surveys in 2008 and 2015, which verified the gap in an...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-12-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.781509/full |
| _version_ | 1818853689507446784 |
|---|---|
| author | Santiago Mencía Santiago Mencía Santiago Mencía Santiago Mencía Raquel Cieza Raquel Cieza Raquel Cieza Raquel Cieza Jimena del Castillo Jimena del Castillo Jimena del Castillo Jimena del Castillo Jesús López-Herce Jesús López-Herce Jesús López-Herce Jesús López-Herce Sedation Group of Spanish Pediatric Critical Care Society (SECIP) Rocío Tapia Raúl Borrego Mercedes Domínguez Cristina Calvo Francisco Fernández Manuel Nieto Ana Estalella Ana Vivanco José Fernández-Cantalejo David Lozano Esther Aleo Raúl Montero Cristina Yun Artur Sharluyan Mónica Riaza Alba Palacios Antonio Rodríguez-Núñez |
| author_facet | Santiago Mencía Santiago Mencía Santiago Mencía Santiago Mencía Raquel Cieza Raquel Cieza Raquel Cieza Raquel Cieza Jimena del Castillo Jimena del Castillo Jimena del Castillo Jimena del Castillo Jesús López-Herce Jesús López-Herce Jesús López-Herce Jesús López-Herce Sedation Group of Spanish Pediatric Critical Care Society (SECIP) Rocío Tapia Raúl Borrego Mercedes Domínguez Cristina Calvo Francisco Fernández Manuel Nieto Ana Estalella Ana Vivanco José Fernández-Cantalejo David Lozano Esther Aleo Raúl Montero Cristina Yun Artur Sharluyan Mónica Riaza Alba Palacios Antonio Rodríguez-Núñez |
| author_sort | Santiago Mencía |
| collection | DOAJ |
| description | Background: Analgosedation (AS) assessment using clinical scales is crucial to follow the international recommendations about analgosedation. The Analgosedation workgroup of the Spanish Society of Pediatric Intensive Care (SECIP) carried out two surveys in 2008 and 2015, which verified the gap in analgosedation assessment in Spanish pediatric intensive care unit (PICUs). The objective of the study was to analyze how analgosedation assessment by clinical scales changed after a multicenter intervention program.Methods: This is a multicenter pre–post study comparing the use of sedation, analgesia, withdrawal, and delirium scales before and after the MONISEDA project. Results were also compared with a control group formed by non-participating units. A survey about analgosedation management and monitoring was filled out before (year 2015) and after (year 2020) the implementation of the MONISEDA project in 2016. Results were compared not only between those periods of time but also between participant and non-participant PICUs in the MONISEDA project (M-group and non-M group, respectively). Data related to analgosedation of all patients admitted to a MONISEDA-participant PICU were also collected for 2 months.Results: Fifteen Spanish PICUs were enrolled in the MONISEDA project and another 15 non-participant PICUs formed the control group. In the M-group, the number of PICUs with a written analgosedation protocol increased from 53 to 100% (p = 0.003) and withdrawal protocol from 53 to 100% (p = 0.003), whereas in the non-M group, the written AS protocol increased from 80 to 87% and the withdrawal protocol stayed on 80%. The number of PICUs with an analgosedation team increased from 7 to 47% in the M-group (p = 0.01) and from 13 to 33% in the non-M group (p = 0.25). In the M-group, routine use of analgosedation clinical scales increased from 7 to 100% (p < 0.001), withdrawal scales from 7% to 86% (p = 0.001), and delirium scales from 7 to 33% (p = 0.125). In the non-M group, the number of PICUs using AS scales increased from 13 to 100% (p < 0.001), withdrawal scales from 7 to 27% (p = 0.125), and delirium scales from 0 to 7% (p = 1).Conclusions: The development of a specific training program improves monitoring and management of analgosedation in PICUs. |
| first_indexed | 2024-12-19T07:40:48Z |
| format | Article |
| id | doaj.art-cdc47bb3a9c94187a72bd6bd69c26b3d |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-19T07:40:48Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-cdc47bb3a9c94187a72bd6bd69c26b3d2022-12-21T20:30:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-12-01910.3389/fped.2021.781509781509MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care UnitsSantiago Mencía0Santiago Mencía1Santiago Mencía2Santiago Mencía3Raquel Cieza4Raquel Cieza5Raquel Cieza6Raquel Cieza7Jimena del Castillo8Jimena del Castillo9Jimena del Castillo10Jimena del Castillo11Jesús López-Herce12Jesús López-Herce13Jesús López-Herce14Jesús López-Herce15Sedation Group of Spanish Pediatric Critical Care Society (SECIP)Rocío TapiaRaúl BorregoMercedes DomínguezCristina CalvoFrancisco FernándezManuel NietoAna EstalellaAna VivancoJosé Fernández-CantalejoDavid LozanoEsther AleoRaúl MonteroCristina YunArtur SharluyanMónica RiazaAlba PalaciosAntonio Rodríguez-NúñezPediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, SpainPublic Health and Mother-Child Department, School of Medicine, Complutense University, Madrid, SpainGregorio Marañón Health Research Institute, Madrid, SpainMother-Child Health and Development Network (Red SAMID) of ISCIII-Sub-Directorate General for Research Assessment and Promotion, European Regional Development Fund, Madrid, SpainPediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, SpainPublic Health and Mother-Child Department, School of Medicine, Complutense University, Madrid, SpainGregorio Marañón Health Research Institute, Madrid, SpainMother-Child Health and Development Network (Red SAMID) of ISCIII-Sub-Directorate General for Research Assessment and Promotion, European Regional Development Fund, Madrid, SpainPediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, SpainPublic Health and Mother-Child Department, School of Medicine, Complutense University, Madrid, SpainGregorio Marañón Health Research Institute, Madrid, SpainMother-Child Health and Development Network (Red SAMID) of ISCIII-Sub-Directorate General for Research Assessment and Promotion, European Regional Development Fund, Madrid, SpainPediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, SpainPublic Health and Mother-Child Department, School of Medicine, Complutense University, Madrid, SpainGregorio Marañón Health Research Institute, Madrid, SpainMother-Child Health and Development Network (Red SAMID) of ISCIII-Sub-Directorate General for Research Assessment and Promotion, European Regional Development Fund, Madrid, SpainBackground: Analgosedation (AS) assessment using clinical scales is crucial to follow the international recommendations about analgosedation. The Analgosedation workgroup of the Spanish Society of Pediatric Intensive Care (SECIP) carried out two surveys in 2008 and 2015, which verified the gap in analgosedation assessment in Spanish pediatric intensive care unit (PICUs). The objective of the study was to analyze how analgosedation assessment by clinical scales changed after a multicenter intervention program.Methods: This is a multicenter pre–post study comparing the use of sedation, analgesia, withdrawal, and delirium scales before and after the MONISEDA project. Results were also compared with a control group formed by non-participating units. A survey about analgosedation management and monitoring was filled out before (year 2015) and after (year 2020) the implementation of the MONISEDA project in 2016. Results were compared not only between those periods of time but also between participant and non-participant PICUs in the MONISEDA project (M-group and non-M group, respectively). Data related to analgosedation of all patients admitted to a MONISEDA-participant PICU were also collected for 2 months.Results: Fifteen Spanish PICUs were enrolled in the MONISEDA project and another 15 non-participant PICUs formed the control group. In the M-group, the number of PICUs with a written analgosedation protocol increased from 53 to 100% (p = 0.003) and withdrawal protocol from 53 to 100% (p = 0.003), whereas in the non-M group, the written AS protocol increased from 80 to 87% and the withdrawal protocol stayed on 80%. The number of PICUs with an analgosedation team increased from 7 to 47% in the M-group (p = 0.01) and from 13 to 33% in the non-M group (p = 0.25). In the M-group, routine use of analgosedation clinical scales increased from 7 to 100% (p < 0.001), withdrawal scales from 7% to 86% (p = 0.001), and delirium scales from 7 to 33% (p = 0.125). In the non-M group, the number of PICUs using AS scales increased from 13 to 100% (p < 0.001), withdrawal scales from 7 to 27% (p = 0.125), and delirium scales from 0 to 7% (p = 1).Conclusions: The development of a specific training program improves monitoring and management of analgosedation in PICUs.https://www.frontiersin.org/articles/10.3389/fped.2021.781509/fullmonitoring analgosedationMONISEDA projectPICUwithdrawal scalesdelirium scales |
| spellingShingle | Santiago Mencía Santiago Mencía Santiago Mencía Santiago Mencía Raquel Cieza Raquel Cieza Raquel Cieza Raquel Cieza Jimena del Castillo Jimena del Castillo Jimena del Castillo Jimena del Castillo Jesús López-Herce Jesús López-Herce Jesús López-Herce Jesús López-Herce Sedation Group of Spanish Pediatric Critical Care Society (SECIP) Rocío Tapia Raúl Borrego Mercedes Domínguez Cristina Calvo Francisco Fernández Manuel Nieto Ana Estalella Ana Vivanco José Fernández-Cantalejo David Lozano Esther Aleo Raúl Montero Cristina Yun Artur Sharluyan Mónica Riaza Alba Palacios Antonio Rodríguez-Núñez MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units Frontiers in Pediatrics monitoring analgosedation MONISEDA project PICU withdrawal scales delirium scales |
| title | MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units |
| title_full | MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units |
| title_fullStr | MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units |
| title_full_unstemmed | MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units |
| title_short | MONISEDA Project: Improving Analgosedation Monitoring in Spanish Pediatric Intensive Care Units |
| title_sort | moniseda project improving analgosedation monitoring in spanish pediatric intensive care units |
| topic | monitoring analgosedation MONISEDA project PICU withdrawal scales delirium scales |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.781509/full |
| work_keys_str_mv | AT santiagomencia monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT santiagomencia monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT santiagomencia monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT santiagomencia monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raquelcieza monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raquelcieza monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raquelcieza monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raquelcieza monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jimenadelcastillo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jimenadelcastillo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jimenadelcastillo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jimenadelcastillo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jesuslopezherce monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jesuslopezherce monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jesuslopezherce monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT jesuslopezherce monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT sedationgroupofspanishpediatriccriticalcaresocietysecip monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT rociotapia monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raulborrego monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT mercedesdominguez monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT cristinacalvo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT franciscofernandez monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT manuelnieto monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT anaestalella monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT anavivanco monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT josefernandezcantalejo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT davidlozano monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT estheraleo monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT raulmontero monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT cristinayun monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT artursharluyan monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT monicariaza monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT albapalacios monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits AT antoniorodrigueznunez monisedaprojectimprovinganalgosedationmonitoringinspanishpediatricintensivecareunits |