Enhancing patient safety during pediatric sedation - The impact of simulation-based training of nonanesthesiologists

Objective: To evaluate the impact of simulation-based education on patient safety during pediatric procedural sedation. Design: A prospective, observational, single-blind, controlled study of pediatric procedural sedation outside the operating room. Setting: Two university teaching hospitals in Israel. Participants: Nonanesthesiologists, with or without training in simulation-based education on patient safety, who routinely perform procedural sedation outside the operating room. These comprise full-time pediatricians practicing emergency medicine and a cohort of pediatric gastroenterologists. Intervention: The study investigators used the internally developed, 9-criteria Sedation Safety Tool to observe and evaluate nonanesthesiologists who were trained in sedation safety and compared their performance with that of colleagues who did not receive similar training. Outcome Measure: For each of the 9 criteria on the evaluation form, odds ratios and 95% confidence intervals were calculated to compare the actions of the individuals in the 2 study groups. Results: Thirty-two clinicians were evaluated. Half of the physicians were graduates of the simulation-based sedation safety course. Significant differences in performance pertaining to patient safety were found between those physicians who did and those who did not complete simulation-based training. Conclusions: Pediatric procedural sedations conducted by simulator-trained nonanesthesiologists were safer. The simulation-based sedation safety course enhanced physician performance during pediatric procedural sedation.