Development of an Evidence-Based Pediatric Preoperative Risk Assessment Checklist

Abstract

PurposeTo describe how a pediatric preoperative risk assessment (PPRA) checklist was developed to inform perianesthesia nurses of potential postanesthesia care unit (PACU) respiratory complications. DesignEvidence-based practice approach. MethodsA systematic search was conducted using PubMed, CINAHL and Cochrane Library databases for this project. In addition, an integrative review process was conducted to develop an assessment checklist of evidence-based pediatric preoperative risk factor criteria associated with PACU respiratory complications. Evidence-based review focused on summarizing and appraising current research for quality levels for each of the individual pediatric preoperative risk factor that comprised the assessment checklist. FindingsEleven risk categories were established: Age, American Society of Anesthesiologists Physical Status, gender, general anesthesia, airway comorbidities, syndromes/congenital anomalies, pulmonary comorbidities, African American ethnicity, obesity, neurologic comorbidities, and cardiac comorbidities. Multidisciplinary experts came to consensus on content and face validity as well as reliability of the PPRA checklist. ConclusionsThe PPRA checklist presents a rapid way to communicate through handoff the preoperative “big picture” to interpret children's acuity and comprehensive risk for significant pediatric respiratory adverse events in the PACU.