PT  - JOURNAL ARTICLE
AU  - Tarek Hazwani
AU  - Arwa Al Ahmady
AU  - Yasser Kazzaz
AU  - Abeer Al Smari
AU  - Seham Al Enizy
AU  - Hamza Alali
TI  - Implementation of a sedation protocol: a quality improvement project to enhance sedation management in the paediatric intensive care unit
AID  - 10.1136/bmjoq-2021-001501
DP  - 2022 Jan 01
TA  - BMJ Open Quality
PG  - e001501
VI  - 11
IP  - 1
4099  - http://bmjopenquality.bmj.com/content/11/1/e001501.short
4100  - http://bmjopenquality.bmj.com/content/11/1/e001501.full
SO  - BMJ Open Qual2022 Jan 01; 11
AB  - Background Proper sedation is integral to ensuring the safety and comfort of children on mechanical ventilation (MV). Sedation protocols help to achieve this goal and reduce the duration of MV. We have observed varied sedation approaches, sedation score targets and sedative use by our physicians, which were manifested as oversedation and undersedation with associated accidental extubation. Hence, we aimed to implement a standardised sedation protocol and assess its impact on mechanically ventilated paediatric patients.Methods A multidisciplinary quality improvement team was formed to develop and implement a standardised sedation protocol for mechanically ventilated paediatric patients. COMFORT-Behaviour (COMFORT-B) Scale score was used to assess the sedation targets and define undersedation, oversedation or adequate sedation. Our goal was to achieve adequate sedation during 90% of the sedation period. Based on the model for improvement methodology, we used plan–do–study–act cycles to develop, test and implement the new sedation protocol.Results There was an immediate percentage increase in COMFORT-B Scale scores within the target sedation level, which was associated with a gradual decrease in the need for intermittent sedation doses over sedation infusion in the preimplementation, improvement and control phases (6.3, 4.9 and 3.1 sedation doses/12 hours/patient, respectively) to achieve adequate sedation target.Conclusions The standardisation of sedation protocols was safe and efficient, and improved the sedation quality in mechanically ventilated paediatric patients.Data are available upon reasonable request. The data underlying this article will be shared on reasonable request to the corresponding author.