Implementation of a Pre-Anesthesia Assessment Tool in a Pediatric Outpatient Procedure Setting

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Breninger, Halie

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2024-04-24

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Purpose: This project’s purpose was to develop a standardized pre-operative screening process that included the addition of a screening tool to identify children at-risk for anesthesia-related respiratory complications. Background: Complications related to anesthesia are three times more common in children, occurring in approximately three to eight percent of pediatric anesthesia cases (Cronjé, 2015; Jagannathan & Burjek, 2022). Identifying risk factors can lead to decreased incidence rates of adverse health effects. Professional organizations highlight the need for routine health evaluation and risk assessment prior to anesthesia (Cotê & Wilson, 2019). Sample/Setting: This project was conducted with REM Anesthesia, a mobile anesthesia practice, in Overland Park, Kansas. Patients under 18 receiving office-based anesthesia were eligible for participation. Methods: A pre-operative anesthesia checklist was developed using current processes and professional organizations’ recommendations. The COLDS scoring tool was incorporated to evaluate for increased risk of respiratory-related events. Nursing staff were educated on the checklist and the COLDS scoring tool. The checklist was completed during the pre-operative phone call and day of anesthesia assessment to review patient information. Completed forms were uploaded into the patient’s medical record on the day of service. Data was collected over nine weeks and analyzed using descriptive statistics and logistic regression. Results: Of 214 eligible children, 210 patient screenings were completed. There was an average weekly compliance of 98.4% for completion of checklists. Documented COLDS scores varied in range from 6 to 12. Of the 198 patients included in the data, 26 patients required respiratory interventions. Patients who required an intervention had statistically significant higher COLDS scores. Post-implementation staff satisfaction survey results indicated nursing staff were satisfied with the new screening process. Conclusion: This project implemented a checklist that standardized the pre-operative screening process for staff. Its use aided in the identification of pediatric patients at higher risk for respiratory events. The COLDS scoring tool can be used to predict children who may need more respiratory interventions during anesthesia.

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Creighton University

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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University

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