Preprinted order sets as a safety intervention in pediatric sedation

Abstract

Objectives: Implement preprinted packets for pediatric procedural sedations to increase documentation compliance and decrease medication ordering errors.

Study design: Retrospective chart review of pediatric inpatients undergoing procedural sedation before and after implementation of a preprinted packet including an order set, consent form, and sedation monitoring form. Patient charts before and after the intervention were reviewed for completeness of medical documentation, correct medication dosages, and adverse events. Chi2 or Fisher exact test was used to determine preintervention vs postintervention differences.

Results: Forty-two charts preintervention and 42 postintervention were reviewed. Documentation compliance increased on consent forms (P < .001), procedure notes (P = .113), and sedation monitoring forms (P = .003), while dating and timing of order forms decreased. Ordering of resuscitation equipment (P = .12), documentation of American Society of Anesthesiologists' (ASA) physical status classification (P < .001) and allergies (P < .001), and postsedation orders (P < .001) also increased. Medications ordered using unit/kg increased 43% (P < .05). Medication ordering errors for sedation agents decreased 64% (P < .001). Ordering of appropriate reversal agents increased 73% (P = .02).

Conclusions: Implementing preprinted physician orders, consent forms, and prepared packets increased documentation compliance and ordering of reversal agents and resuscitation equipment. Medication dosage ordering errors decreased.