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Leroy PL, Krauss BS, Costa LR, Barbi E, Irwin MG, Carlson DW, Absalom A, Andolfatto G, Roback MG, Babl FE, Mason KP, Roelofse J, Costa PS, Green SM. Procedural sedation competencies: a review and multidisciplinary international consensus statement on knowledge, skills, training, and credentialing. Br J Anaesth 2024:S0007-0912(24)00498-7. [PMID: 39327154 DOI: 10.1016/j.bja.2024.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 09/28/2024] Open
Abstract
Procedural sedation is practised by a heterogeneous group of practitioners working in a wide array of settings. However, there are currently no accepted standards for the competencies a sedation practitioner should have, the content of sedation training programmes, and guidelines for credentialing. The multidisciplinary International Committee for the Advancement of Procedural Sedation sought to develop a consensus statement on the following: which competencies should medical or dental practitioners have for procedural sedation and how are they obtained, assessed, maintained, and privileged. Using the framework of Competency-Based Medical Education, the practice of procedural sedation was defined as a complex professional task requiring demonstrable integration of different competencies. For each question, the results of a literature review were synthetised into preliminary statements. Following an iterative Delphi review method, final consensus was reached. Using multispeciality consensus, we defined procedural sedation competence by identifying a set of core competencies in the domains of knowledge, skills, and attitudes across physical safety, effectiveness, psychological safety, and deliberate practice. In addition, we present a standardised framework for competency-based training and credentialing of procedural sedation practitioners.
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Affiliation(s)
- Piet L Leroy
- Department of Pediatrics, Maastricht University Medical Centre and School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
| | - Baruch S Krauss
- Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Luciane R Costa
- Department of Pediatric Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Egidio Barbi
- Department of Pediatrics, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Michael G Irwin
- Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Douglas W Carlson
- Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Anthony Absalom
- Department of Anaesthesia, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gary Andolfatto
- University of British Columbia Department of Emergency Medicine, Lions Gate Hospital, North Vancouver, British Columbia, Canada
| | - Mark G Roback
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Franz E Babl
- Departments of Paediatrics and Critical Care, University of Melbourne, Emergency Department, Royal Children's Hospital, Emergency Research, Murdoch Children's Research Institute, Parkville, WA, Australia
| | - Keira P Mason
- Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - James Roelofse
- Departments of Anaesthesia, University of the Western Cape, Stellenbosch University, Tygerberg, Republic of South Africa
| | - Paulo S Costa
- Department of Pediatrics, Federal University of Goias, Goiania, Goias, Brazil
| | - Steven M Green
- Department of Emergency Medicine, Loma Linda University, Loma Linda, CA, USA
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Neufeld M, Ripley P. Embracing creativity in child and youth health research: Using participatory video to engage young people in rights-based research. J Pediatr Nurs 2024; 78:x-xi. [PMID: 39112122 DOI: 10.1016/j.pedn.2024.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Affiliation(s)
- Michael Neufeld
- Auckland University of Technology, School of Clinical Sciences, 90 Akoranga Road, Northcote, Auckland, 0627, New Zealand.
| | - Paul Ripley
- Auckland University of Technology, School of Clinical Sciences, 90 Akoranga Road, Northcote, Auckland, 0627, New Zealand.
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Graber K, O'Farrelly C, Ramchandani P. Centring children's lived experiences in understanding the importance of play in hospitals. Child Care Health Dev 2024; 50:e13287. [PMID: 38958339 DOI: 10.1111/cch.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/02/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Children have a right to participate in matters affecting their lives. With increasing regularity, children's perspectives are being sought regarding their health and health care experiences. Though there is evidence that children find play to be one of the 'best' aspects of hospitalisation, studies rarely focus on children's perspectives on play in hospital. METHODS This qualitative study explored children's lived experiences of play during hospitalisation. Over five months, ethnographic observations were conducted on a paediatric oncology ward as well as interviews with 16 children ages 3-13 years. RESULTS Using interpretative phenomenological analysis, children's expressions and experiences illuminated three key points: safety and comfort are integral to children feeling able to play in hospital; the value and efficacy of play is decided by children; and that play is a way for patients to be (and be treated as) children first. CONCLUSION Hospitals can only be child-friendly if children find them friendly. Listening to and integrating children's perspectives in the discourse around the importance of play in hospital is essential for respecting children's rights and delivering person-centred paediatric healthcare.
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Affiliation(s)
- Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
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Jeppesen E, Schmidt AA, Skjødt CK, Hybschmann J, Gjærde LK, Thestrup J, Hansson H, Sørensen JL. Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review. Eur J Pediatr 2024; 183:2015-2028. [PMID: 38430279 PMCID: PMC11035470 DOI: 10.1007/s00431-024-05455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
To identify and describe educational programmes in patient- and family-centred care for paediatric healthcare professionals. This scoping review was conducted and reported according to the JBI Manual for Evidence Synthesis and the PRISMA guideline. The databases searched included MEDLINE (PubMed), PsycINFO, CINAHL, Scopus, Cochrane, and Embase. Inclusion criteria were experimental, observational and qualitative studies about educational programmes on patient- and family-centred care for paediatric healthcare professionals. Exclusion criteria were reviews and non-peer-reviewed literature. Two reviewers independently screened and extracted the data using Covidence. Of the 13922 records identified, 49 articles met the inclusion criteria. There was a large variety of educational programmes, half of which were interdisciplinary, that mainly targeted nurses and doctors. The median number of participants was 51 (range 7 to 1411). The predominant target population was children with chronic disabilities and neonatal intensive care units, and only one programme specifically targeted adolescents. The median duration was one day (range 5 min to 3.5 years). Development of competencies was the most common objective. We identified 12 different educational content areas. Content mainly focused on communication and relational competencies, including partnership, which involved shared decision-making, mutual agenda setting, and negotiation of a plan. Many kinds of educational strategies were found but experiential learning through simulation and roleplay was used most. Conclusion: A large variety of educational programmes in paediatric patient- and family-centred care exist. Educational content mainly focused on communication and relational competencies. Experiential learning including roleplay and simulation was the most used educational strategy. What is Known: • Delivery of patient- and family-centred care improves parental satisfaction of care but requires clinicians have a certain attitude towards involving the child and parents in a healthcare partnership as well as advanced triadic communication skills. Little is known about how this attitude, and more broadly, patient- and family-centred care, can be facilitated through education and training. What is New: • This scoping review found a wide array of programmes.. Workshops with simulation or roleplay was the most frequent educational strategy. The programmes, which typically targeted nurses and doctors, chiefly focused on basic and advanced communication and relational competencies, including partnership, which involved shared decision-making and negotiation of plans.
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Affiliation(s)
- Elisabeth Jeppesen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.
- Department of Respiratory Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Anne Aarslev Schmidt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Camilla Kriegbaum Skjødt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Hansson
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Thestrup J, Sørensen JL, Hybschmann J, Topperzer MK, Graber K, O'Farrelly C, Gibson J, Ramchandani P, Frandsen TL, Gjærde LK. Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study. Eur J Pediatr 2024; 183:1595-1605. [PMID: 38183437 PMCID: PMC11001713 DOI: 10.1007/s00431-023-05411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives. Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.
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Affiliation(s)
- Jakob Thestrup
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark.
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | | | - Kelsey Graber
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Christine O'Farrelly
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Jenny Gibson
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Paul Ramchandani
- Centre for Research on Play in Education, Development & Learning (PEDAL), Faculty of Education, Cambridge University, Cambridge, UK
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Juliane Maries Vej 4, 2100, Copenhagen, Denmark
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