Effects of Pediatric Emergence Delirium Education on Analgesic Administration by PACU Nurses: A Pilot Study

Abstract

Background: Emergence delirium (ED) is a behavioral disturbance as a result of general anesthesia that commonly occurs in pediatric patients. Adverse effects of ED lead to a complicated recovery from anesthesia leading to the increased use of sedatives and analgesics. Due to the multiple ramifications of ED, PACU nurses need to provide appropriate care to promote a safe recovery process from anesthesia while avoiding unnecessary use of analgesics. The Pediatric Assessment Emergence Delirium (PAED) tool has been successfully utilized in recognizing ED in PACU. Purpose: The purpose of this evidence-based practice project was to educate PACU nurses about the use of the PAED tool, and explore the post-education effect on the nurses’ use of analgesics in the immediate post-op period. Method: This project utilized a pre- and post- interventional study design. Twenty-eight charts of pediatric post-op patients were screened pre-intervention for analgesic use. An educational session on ED and instruction on the use of the PAED tool were provided to PACU nurses. After six weeks, 24 charts were reviewed for analgesic administration. The results of pre and post analgesic use were compared by using Fisher’s exact test of independence. Results: Findings revealed an overall non-significant decrease in analgesic use from 21% (n=6) to 17% (n=4) between pre-intervention and post-intervention groups (x2 = 0.189, p = .47), though a decrease in the use of stadol was observed from 11% (n=3) to 0%. Conclusion: ED education with PAED use has the potential to influence PACU nurses’ usage of analgesics. Follow up studies with larger sample sizes are needed to explore such an influence further.