Use of a sedation-analgesia datasheet in closed shoulder reductions.
A three-page conscious sedation (CS) monitoring datasheet and sedation-analgesia policy were implemented at the Lincoln Hospital Emergency Department (LHED) to maintain compliance with JCAHO and New York State standards on CS monitoring. The datasheet included areas for physical examination, medications, and vital signs. To determine effects of the new datasheet and policy, charts containing all closed shoulder reductions done at LHED from April 3, 1996 to June 30, 1999 (n = 237) were reviewed for use of CS, defined as the use of an analgesic and sedative-hypnotic concurrently. Utilization of CS during equal time periods of 591 days before and after datasheet implementation was analyzed and compared. Before use of the datasheet, 64.3% received CS before closed shoulder reduction, compared with 41.8% after its use began (p < 0.05). A subsequent survey was conducted to determine physician perception of the CS datasheet. Attending-level LHED physicians suggested that use of the datasheet increased charting time and liability.
Swoboda
Thomas K
TK
Department of Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Munyak
John
J
D000328:Adult; D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000592:standards* / Q000706:statistics & numerical data*; D004282:Documentation / Q000592:standards* / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008485:Medical Audit; D009518:New York; D012783:Shoulder Dislocation / Q000628:therapy*