Date of Award

8-4-2016

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Christina Cavinder

Abstract

Emergence delirium (ED) is a behavioral disturbance as a result of general anesthesia that commonly occurs in pediatric patients. Adverse effects of ED lead to a complicated recovery from anesthesia due to the risk of self-inflicted injury of patients, the disturbance of surgical incisions, the development of postoperative maladaptive behaviors, and the increased use of sedatives and analgesics resulting in prolonged recovery time and delayed discharge from the post-anesthesia care unit (PACU). Due to the multiple ramifications of ED, appropriate care is needed to promote a safe recovery from anesthesia and an optimum perioperative experience for these patients. As PACU nurses are the primary providers of care to this population group during the occurrence of ED, it is imperative they are able to recognize and manage ED appropriately. The goal of this evidence-based practice project was to increase the knowledge of ED among PACU nurses and determine its effects on analgesic usage among pediatric surgical patients in the PACU. Using the Iowa model of evidence-based practice in developing quality care, an educational session on ED was developed and provided to PACU nurses of a large, Midwestern hospital in regards to the identification of the occurrence, associated risk factors, multifactorial causes, and effective treatment options for ED. A two-group comparative design was used based on medical records selected using a convenience sampling. Pre-intervention group data was collected from 28 samples prior to the educational sessions and post intervention group data was collected from 24 samples after the implementation. Findings revealed an overall decrease in analgesic use with a significant decrease in the use of stadol, while the use of acetaminophen and fentanyl increased. Data also demonstrated higher PAED scores correlated positively with weight and being of Hispanic race. The results of this EBP project lend limited support for the use of ED education to affect analgesic usage among PACU nurses.

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