Gernhold Christa, Kundtner Nina, Steinmair Martin, Henkel Martin, Oswald Josef, Haid Bernhard
Department of Pediatric Urology, Hospital of the Sisters of Charity, Seilerstätte 4, 4020 Linz, Austria.
Department of Nuclear Medicine, Hospital of the Sisters of Charity, Seilerstätte 4, 4020 Linz, Austria.
Children (Basel). 2021 May 20;8(5):424. doi: 10.3390/children8050424.
Nuclear medicine investigations are essential diagnostic tools in paediatric urology. Child-orientated examination techniques and the avoidance of sedation or anaesthesia vary in different institutions. We aimed at evaluating child friendly measures in our department to identify the potential for improvement. Based on these data, we changed the standards regarding the sedation policy and consequently re-evaluated sedation rates.
Four-hundred thirty-five consecutive investigations were evaluated regarding the need for sedation, outcome and patient satisfaction at our department. After the revision of our department standards, we re-evaluated 159 examinations. Statistical analysis was performed with JUMBO (Java-supported Münsterian biometrical platform).
Eighty-six percent (60/70) would agree to perform an investigation under identical conditions again. Seventy-seven percent (17/22) of eligible patients >5 years of age felt good during the investigation. By changing our sedation policy, we could reduce the sedation rate from 27.1% to 7.5% ( < 0.0001; OR 0.219 95% CI 0.111-0.423).
The evaluation of child friendly examination protocols demonstrated high reliability and patient satisfaction using situational sedation with a relatively high proportion of patients being sedated. Through protocol adaption with clear age limits, individual indication and education of staff, as well as the use of optimized sedatives, the need for sedation could be further reduced whilst maintaining a high patient satisfaction.
核医学检查是小儿泌尿外科重要的诊断工具。不同机构针对儿童的检查技术以及避免使用镇静剂或麻醉的方法各不相同。我们旨在评估本科室对儿童友好的措施，以确定改进的潜力。基于这些数据，我们更改了镇静政策标准，并因此重新评估了镇静率。
对本科室连续进行的435例检查的镇静需求、结果及患者满意度进行评估。修订科室标准后，我们重新评估了159例检查。使用JUMBO（Java支持的明斯特生物统计学平台）进行统计分析。
86%（60/70）的患者表示愿意在相同条件下再次接受检查。77%（17/22）的5岁以上符合条件的患者在检查过程中感觉良好。通过更改镇静政策，我们将镇静率从27.1%降至7.5%（P<0.0001；OR 0.219，95%CI 0.111 - 0.423）。
对儿童友好检查方案的评估表明，采用情境镇静时可靠性高且患者满意度高，接受镇静的患者比例相对较高。通过制定明确年龄限制、个体化适应症及对工作人员进行培训的方案，以及使用优化的镇静剂，在保持高患者满意度的同时，可进一步降低镇静需求。
