Associate Professor of Medicine Baylor College of Medicine Houston, Texas, United States
Background: Procedures and imaging studies are a source of anxiety and pain for patients. Over the past decade, procedural sedation and analgesia (PSA) has been utilized outside the operating room yet no standard satisfaction tool exists.A pediatric sedation satisfaction survey was developed using modified Delphi technique for validation across PSA settings.
Objective: To implement and validate a PSA satisfaction scale outside the operating room and to understand the tools’ performance in a variety of settings, procedure types, and languages.
Design/Methods: A convenience sample of children undergoing sedation by multidisciplinary faculty were enrolled from February 26, 2020 through October 28, 2022 in 5 diverse institutions in three settings (emergency department, outpatient sedation unit, and radiology). Patients were excluded if they were < 6 months of age or had caregivers that spoke languages other than English or Spanish. A PSA survey was developed through modified Delphi method and administered on paper, smart phone, or tablet computer.Descriptive statistics were reported with means (SD) and medians (IQR). Survey responses were assessed for reliability using the corrected item total correlation and Cronbach’s alpha if an item was deleted.Summations for each construct was calculated and univariate analyses were reported, along with correlations of each sedation item with its own construct total score.
Results: 765/805 (95.4%) caregivers participated in the study evenly across the 5 sites, with the majority of PSA for painless procedures in the radiology unit (Table 1). Responses were overall positive (Table 2).When assessing the correlations for all questions (excluding constructs), all corrected item-total correlations were >0.30, therefore, and remained included in the tool (Table 3). The Cronbach’s alpha if item was deleted was high for all survey questions (≥.95) (Table 3). When the item analysis considers the multiple constructs, the lowest correlation was 0.57 for nausea and vomiting and 0.69 for outside sedation team was respectful (Table 3). When stratified by survey language, there were no significant differences in the overall score (p=0.36).
Conclusion(s): This study presents a short and simple satisfaction tool for PSA outside the operating room. Over 90% of guardians would recommend the sedation team to their friends and family. Given the small number of Spanish respondents, more work needs to be done to validate the tool in this population.
