Satisfaction With the Withdrawal Assessment Tool-1 (WAT-1)
Satisfaction With the Withdrawal Assessment Tool-1 (WAT-1)
Background: Use of opioids and benzodiazepines in critically ill children results in an increased risk of withdrawal syndrome requiring the pediatric nurse to accurately assess the patient's clinical state. A valid and reliable pediatric withdrawal assessment tool could be of considerable value to improve nursing care.
Objective: To evaluate nurses' satisfaction with a new pediatric assessment tool, the Withdrawal Assessment Tool-1 (WAT-1).
Methods: Forty-one Pediatric Intensive Care Unit (PICU) and 27 Pediatric Intermediate Care Unit (PIMC) staff participated in a pre- and post-implementation survey. The survey looked at confidence in assessment skills, perception of communication about withdrawal, and satisfaction with nursing care of the child undergoing withdrawal syndrome. Staff were surveyed, completed online education about the WAT-1, and then repeated the survey after six months of clinical use.
Results: Overall confidence in assessment changed very little. There was improvement in the perception of communication (p = 0.005) as well as satisfaction with care provided (p = 0.00002) after implementation of the WAT-1. In particular, satisfaction with nursing documentation of withdrawal syndrome im proved significantly (p = 0.00002).
Conclusions: The WAT-1 improves nurses' satisfaction with their care of children undergoing withdrawal syndrome, in particular, their documentation of the level of withdrawal symptoms.
The use of opioids and benzodiazepines in critically ill children to relieve pain and anxiety during their management in pediatric intensive care is now a standard of practice (Ista, van Dijk, Gamel, Tibboel, & deHoog, 2007). Unfortunately, children with prolonged exposure to these medications are shown to be at risk for withdrawal syndrome, including tremors, agitation, fevers, profuse sweating, vomiting, and diarrhea (Dominguez, Lomako, Katz, & Kelly, 2003; Fonsmark, Rasmussen, & Carl, 1999; Katz, Kelly, & Hsi, 1994). Watching a child suffer through these symptoms when treatment is available is unacceptable. Therefore, one crucial nursing goal is to provide patient comfort, placing a priority on adequately assessing and effectively communicating the level of a child's withdrawal symptoms. An inability to do so can cause frustration and leave nurses feeling dissatisfied.
The Withdrawal Assessment Tool-1 (WAT-1) was designed to help assess children suffering from withdrawal symptoms (Franck, Harris, Soetenga, Amling, & Curley, 2008). The WAT-1 could be a valuable new tool for pediatric nurses, but will it improve nurses' feelings of satisfaction with the care they provide? This study was conducted to begin to answer that question by determining whether the WAT-1 helps nurses assess their patients' withdrawal symptoms, communicate that assess ment to medical colleagues, and ultimately, improve the quality of care these patients receive.
Abstract and Introduction
Abstract
Background: Use of opioids and benzodiazepines in critically ill children results in an increased risk of withdrawal syndrome requiring the pediatric nurse to accurately assess the patient's clinical state. A valid and reliable pediatric withdrawal assessment tool could be of considerable value to improve nursing care.
Objective: To evaluate nurses' satisfaction with a new pediatric assessment tool, the Withdrawal Assessment Tool-1 (WAT-1).
Methods: Forty-one Pediatric Intensive Care Unit (PICU) and 27 Pediatric Intermediate Care Unit (PIMC) staff participated in a pre- and post-implementation survey. The survey looked at confidence in assessment skills, perception of communication about withdrawal, and satisfaction with nursing care of the child undergoing withdrawal syndrome. Staff were surveyed, completed online education about the WAT-1, and then repeated the survey after six months of clinical use.
Results: Overall confidence in assessment changed very little. There was improvement in the perception of communication (p = 0.005) as well as satisfaction with care provided (p = 0.00002) after implementation of the WAT-1. In particular, satisfaction with nursing documentation of withdrawal syndrome im proved significantly (p = 0.00002).
Conclusions: The WAT-1 improves nurses' satisfaction with their care of children undergoing withdrawal syndrome, in particular, their documentation of the level of withdrawal symptoms.
Introduction
The use of opioids and benzodiazepines in critically ill children to relieve pain and anxiety during their management in pediatric intensive care is now a standard of practice (Ista, van Dijk, Gamel, Tibboel, & deHoog, 2007). Unfortunately, children with prolonged exposure to these medications are shown to be at risk for withdrawal syndrome, including tremors, agitation, fevers, profuse sweating, vomiting, and diarrhea (Dominguez, Lomako, Katz, & Kelly, 2003; Fonsmark, Rasmussen, & Carl, 1999; Katz, Kelly, & Hsi, 1994). Watching a child suffer through these symptoms when treatment is available is unacceptable. Therefore, one crucial nursing goal is to provide patient comfort, placing a priority on adequately assessing and effectively communicating the level of a child's withdrawal symptoms. An inability to do so can cause frustration and leave nurses feeling dissatisfied.
The Withdrawal Assessment Tool-1 (WAT-1) was designed to help assess children suffering from withdrawal symptoms (Franck, Harris, Soetenga, Amling, & Curley, 2008). The WAT-1 could be a valuable new tool for pediatric nurses, but will it improve nurses' feelings of satisfaction with the care they provide? This study was conducted to begin to answer that question by determining whether the WAT-1 helps nurses assess their patients' withdrawal symptoms, communicate that assess ment to medical colleagues, and ultimately, improve the quality of care these patients receive.
