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Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit

Overview of attention for article published in Annals of Intensive Care, March 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (74th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

news
1 news outlet

Citations

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31 Dimensions

Readers on

mendeley
111 Mendeley
Title
Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit
Published in
Annals of Intensive Care, March 2017
DOI 10.1186/s13613-017-0256-7
Pubmed ID
Authors

Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet

Abstract

Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact. We conducted a before and after protocol implementation study in a population of children aged 0-18 years who required mechanical ventilation for at least 24 h between January 2013 and March 2015. After the protocol implementation in January 2014, nurses managed analgesia and sedation following an algorithm that included the COMFORT behaviour scale (COMFORT-B). Duration of mechanical ventilation was the primary outcome; secondary outcomes were total doses and duration of medications, PICU length of stay, incidence of ventilator-associated pneumonia, and occurrence of withdrawal symptoms. Pre-post analysis followed with segmented regression analysis of interrupted time series was used to assess the effect of protocol. A total of 200 children were analysed, including 107 before implementation and 93 children after implementation of the protocol. After implementation of the protocol, the total number of COMFORT-B scores per day of mechanical ventilation significantly increased from 3.9 ± 2.5 times during the pre-implementation period to 6.6 ± 3.5 times during the post-implementation period (p < 10(-3)). Mean duration of mechanical ventilation tended to be lower in the post-implementation period (8.3 ± 7.3 vs 6.6 ± 5.6 days, p = 0.094), but changes in either the trend per trimester from pre-implementation to post-implementation (p = 0.933) or the immediate change after implementation (p = 0.923) were not significant with segmented regression analysis. No significant change between pre- and post-implementation was shown for total dose of sedatives, withdrawal symptoms, agitation episodes, or unplanned endotracheal extubations. These results were promising and suggested that implementation of a nurse-driven sedation protocol in a PICU was feasible. Evaluation of sedation and analgesia was better after the protocol implementation; duration of mechanical ventilation and occurrence of withdrawal symptoms tended to be reduced.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 111 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 111 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 23%
Other 7 6%
Student > Ph. D. Student 7 6%
Student > Bachelor 7 6%
Researcher 6 5%
Other 27 24%
Unknown 31 28%
Readers by discipline Count As %
Nursing and Health Professions 29 26%
Medicine and Dentistry 27 24%
Pharmacology, Toxicology and Pharmaceutical Science 7 6%
Unspecified 5 5%
Biochemistry, Genetics and Molecular Biology 3 3%
Other 6 5%
Unknown 34 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 June 2018.
All research outputs
#4,241,203
of 23,092,602 outputs
Outputs from Annals of Intensive Care
#479
of 1,052 outputs
Outputs of similar age
#75,620
of 309,442 outputs
Outputs of similar age from Annals of Intensive Care
#12
of 26 outputs
Altmetric has tracked 23,092,602 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,052 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.9. This one has gotten more attention than average, scoring higher than 53% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 309,442 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.
We're also able to compare this research output to 26 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.