Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Paediatr Anaesth. 2023 May;33(5):347-354. doi: 10.1111/pan.14625. Epub 2023 Jan 9.
The induction of anesthesia in children poses a challenge for the anesthesiologist, the parent and child. Anxiety and negative behaviours and strategies that effectively mitigate should be documented accurately and be available for future patient encounters. To address the need for a structured and standardized electronic documentation tool.
Our aim was to develop a comprehensive electronic tool to capture and report behaviours during induction of anesthesia.
We performed a literature search on existing validated tools for documenting behaviours during anesthesia induction. We used the nominal group technique to achieve agreement on the components to include. We used Agile software development techniques to design and review the integrated electronic tool. Twelve international hospitals informed the development of the tool.
We developed an electronic tool, the Standardized Anesthesia InductioN Tool (SAINT). SAINT incorporates validated scales for documenting key stages of the anesthesia induction journey (separation from caregivers, mask acceptance, induction behaviour, parental presence, the use of adjuncts and their effectiveness). In addition, the standardised data elements used in SAINT allow for local reporting, quality metrics and can assist in data across multi-centre trials. To date the tool has been adopted by 133 institutions across four countries and is freely available.
We show that collaborative development and rapid adoption of the comprehensive induction tool SAINT has led to its rapid adoption in the routine practice of pediatric anesthesiology across several countries. Further studies on how the SAINT is being used for quality improvement or research are warranted.
儿童麻醉诱导对麻醉师、家长和儿童都是一个挑战。焦虑和负面行为以及有效的缓解策略应准确记录,并可用于未来的患者就诊。为了满足对结构化和标准化电子文档工具的需求。
我们的目标是开发一种全面的电子工具,以捕捉和报告麻醉诱导期间的行为。
我们对现有的用于记录麻醉诱导期间行为的经过验证的工具进行了文献检索。我们使用名义小组技术就纳入的组件达成一致。我们使用敏捷软件开发技术来设计和审查集成的电子工具。12 家国际医院参与了该工具的开发。
我们开发了一种电子工具,即标准化麻醉诱导工具(SAINT)。SAINT 纳入了经过验证的量表,用于记录麻醉诱导过程的关键阶段(与照顾者分离、面罩接受、诱导行为、父母在场、辅助手段的使用及其效果)。此外,SAINT 中使用的标准化数据元素允许进行本地报告、质量指标,并有助于多中心试验中的数据收集。迄今为止,该工具已在四个国家的 133 个机构采用,并免费提供。
我们表明,全面诱导工具 SAINT 的协作开发和快速采用导致其在几个国家的儿科麻醉常规实践中迅速采用。需要进一步研究 SAINT 如何用于质量改进或研究。