Criteria of peer reply post [post 2]:
· Responds to a peer and provides feedback on the student's healthcare topic and research question supported by literature.
· Briefly clarify why you choose this health issue to respond to.
· Use two articles [different from peer’s ones] to discuss the health issue. Recent articles within the last 5 years last 10 years should be included, from XXXXXXXXXXand onward.
· Conclusion and future recommendations.
Bronte Ashcroft XXXXXXXXXX NUR256 Assessment Two- Discussion Board
Pre-procedural or pre-operative distress in paediatric patients is a significant concern for the patient, their families, and the multidisciplinary team. Paediatric patients experience behavioural stress, anxiety, separation from their families and are confronted with unfamiliar environments when undergoing procedures or surgery (Manso et al., XXXXXXXXXXMidazolam is used as a sedative medication that allows paediatric patients to remain calm, which further prevents interventions such as; cancellation, negative pre and post-procedure experiences, and rescheduling. Minimal sedation using Midazolam, which is an effective benzodiazepine, can be beneficial. However, it may have adverse effects such as nausea and vomiting, paradoxical events, and respiratory depression (Dundee et al., XXXXXXXXXXMidazolam is short-acting and is administered orally in paediatrics before procedures or pre-operative and requires patient monitoring and has an effect within 45 minutes (Manso et al., 2019).
The usage of Midazolam in paediatric patient’s pre-procedural or pre-operative is a healthcare topic of high significance to me as I cu
ently work clinically on an acute surgical ward as an Endorsed Enrolled Nurse. Therefore, this research topic has enabled me to
oaden my knowledge and better understand the benefits of Midazolam In paediatrics when experiencing high stress and anxiety.
Research Question
Are pre-procedural or pre-operative paediatric patients who have Midazolam as a premedication compared with those who do not have Midazolam at greater risk of anxiety and post procedure distress?
P- Preprocedural and pre-operative paediatric patients
I – Sedation using Midazolam
C: Midazolam or placebo
O: Reduced anxiety and distress in paediatric patients
The PICO framework guided me to propose this research question and will allow researchers to use a quantitative approach. Quantitative research collects numerical information, analyses results statistically, and demonstrates the cause and effect (Greenhalgh et al., 2020).
The first article assesses the effectiveness of oral Midazolam in paediatric patient’s pre-procedural or pre-operative through a systemic review of the literature. A total of 25 paediatric clinical trials were assessed. The clinical trials that were evaluated had a variety of measures such as sedation effectiveness, response rates, dosage, and usage of placebo. This study concluded that oral Midazolam is a safe medication for sedation in paediatrics from 4 months to 18 years old to reduce behavioural stress. However, there was variability in the rating scales, midazolam dosage, the context of sedation, and the age of patients. There was difficulty in comparing results from the different studies, emphasizing the importance of using validated scales in further studies (Manso et al., 2019).
The second article linked to this topic is a clinical trial study with 62 paediatric patients undergoing a dental procedure. The patients were randomly divided into study and control groups, and the study group received 20mls of orange juice with 0.5mg/kg of Midazolam, while the control group received no midazolam(placebo). The findings of this trial resulted in the study group had a comfortable separation from parents, successful insertion of IVC and completion of the procedure, and the patients did not have a negative pre and post-anaesthetic experience. In comparison, the control group who received the placebo had heightened anxiety and difficult separation from family. In conclusion, Midazolam 20 minutes before the procedure positively affects paediatric patients (Kaviani et al., 2014).
References
Manso, M., Guittet, C., Vandenhende, F., & Granier, L. (2019, November). Efficacy of oral Midazolam for minimal and moderate sedation in pediatric patients.: EBSCOhost. EBSCO Publishing Service Selection Page.
https:
web.a.ebscohost.com/ehost/detail/detail?vid=4&sid=c6f249f XXXXXXXXXXa12c-15b265ec4957%40sdc-v-sessmgr01&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1laG9zdC1saXZl#db=aph&AN= XXXXXXXXXX
Greenhalgh, T., Bidwell, J., Crisp, E., Lam
os, A., & Warland, J XXXXXXXXXXUnderstanding research methods for evidence-based practice in health (Second edition.). John Wiley & Sons Australia.
Kaviani, N., Shahtusi, M., Tehrani, M., & Nazarid, S. (2014, September). Effect of oral Midazolam premedication on children's Co-operation before general anaesthesia in pediatric dentistry. PubMed Central (PMC). https:
www.ncbi.nlm.nih.gov/pmc/articles/PMC4149894/
Dundee, J., Halliday, N., Harper, K., & Brogden, R. (2012, October 12). Midazolam. Drugs. https:
link.springer.com/article/10.2165/ XXXXXXXXXX00002
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