Using Secondary Data to Describe Registered Nurse Sedation Practices and Adverse Events in Radiology
Using Secondary Data to Describe Registered Nurse Sedation Practices and Adverse Events in Radiology Author:Nancy Crego PhD, RN, CCRN Affiliation: Duke University School of Nursing Introduction: Few studies describe registered nurse (RN) sedation practices or adverse events. Studies describing RN sedation adverse events often lack the sample size necessary to detect these occurrences. The author obtained secondary data from the Pediatric Sedation Research Consortium (PSRC) to describe the patient characteristics, medications delivered, monitoring practices and outcomes of children sedated by RNs for diagnostic Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) and ultrasound procedures. Methods: A descriptive research design using the PSRC database was used to explore patient characteristics, sedation practices and outcomes of children sedated by RNs for diagnostic radiology procedures. After review by the University of Virginia Institutional Review Board, a sample of 41,292 cases of children up to and including age 14 years, sedated for diagnostic MRI, CT scan or ultrasound from January 2005 to September 2007 were obtained from the PSRC. (Crego, 2014) Only cases with a documented ASA score, in which at least one medication was administered and the RN was the only provider administering and monitoring the patient were included in the study sample of 12,584 cases. Crego (2014) Results: There were 727 adverse events, no deaths, cardiac arrests intubations or aspirations reported. The most common adverse event was inadequate sedation/agitation/delirium 196 cases and desaturation below baseline for more than 30 seconds, 173 cases. American Society of Anesthesiologist (ASA) physical status classification scores for the cases sedated only by an RN were proportionately similar to those reported by Cravero (2006) using the PSRC data to describe characteristics of children sedated by physicians and advanced practice providers. Discussion: The PSRC data was used to develop a deeper understanding of RN specific sedation practices, adverse events and patient characteristics in radiology. Further research to understand differences in adverse events depending on the type of procedure and provider could inform the process used to determine the appropriate sedation provider. References: Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, Gelman B; Pediatric Sedation Research Consortium. Pediatrics. 2006 Sep;118(3):1087-96. Pediatric Sedation: Using Secondary Data to Describe Registered Nurse Practice in Radiology. Crego, N Journal of radiology Nursing, 2014 Dec; 33(4):166-180
