Get access

Development and implementation of an education and credentialing programme to provide safe paediatric procedural sedation in emergency departments

Authors


  • Franz Babl, MD, MPH, FRACP, FAAP, Consultant Emergency Paediatrician; Stephen Priestley, MB BS, FACEM, Director Emergency Department; David Krieser, MB BS, FACEM, Consultant Emergency Paediatrician; Joanne Miller, RN, Nurse Educator; Melissa Tully, RN, Nurse Educator; Maureen Spicer, PhD, Research Coordinator; Vicki McGowan, RN, Nurse Educator; Natashia Dilla, MB BS, FRACP, Consultant Paediatrician.

Dr Franz E Babl, Emergency Department, Royal Children’s Hospital, Parkville, Vic. 3052, Australia. Email: franz.babl@rch.org.au

Abstract

Objective:  In the conduct of paediatric procedural sedation (PPS) within the ED the combination of powerful drugs, variable competency levels and high staff turnover carry the potential for sedation-associated adverse events. Yet, currently, there is no set programme for education and accreditation of ED staff in PPS. We set out to develop such a programme.

Methods:  We outline the development process of a comprehensive multidisciplinary PPS programme and present its key educational elements (sedation manual, lecture, treatment order form and checklist, parent information handout) and credentialing through multiple-choice questions and competency assessments. We describe issues associated with the implementation of the programme at a metropolitan mixed ED and the ED of a major tertiary paediatric centre.

Results:  Since its inception a total of 294 emergency staff have either completed or have partially completed the programme. Staff feedback showed that the majority of staff scored the elements of the programme as very good to excellent, and felt that their sedation skills had improved and their practice was safer. The development and implementation of the PPS programme raised many issues and posed a number of challenges. We describe the strategies we used to overcome such challenges and barriers.

Conclusion:  We present the development and implementation of a comprehensive PPS programme for emergency staff. As a result of the multicentre development process involving a community and a tertiary paediatric ED the programme will likely have broad applicability in different types of ED caring for children.

Ancillary