• Claire Magner, Abraham J Valkenburg, Dermot Doherty, Monique van Dijk, Brendan O'Hare, Ricardo Segurado, and Seamus Cowman.
• Lecturer In Children's Nursing, University College Dublin, Belfield, Dublin, Ireland, D04 V1W8. Electronic address: claire.magner@ucd.ie.
• Intensive Crit Care Nurs. 2020 Oct 1; 60: 102879.

IntroductionEnhanced clinical outcomes in the Paediatric Intensive Care Unit following standardisation of analgesia and sedation practice are reported. Little is known about the impact of standardisation of analgesia and sedation practice including incorporation of a validated distress assessment instrument on infants post cardiac surgery, a subset of whom have Trisomy 21. This study investigated whether the parallel introduction of nurse-led analgesia and sedation guidelines including regular distress assessment would impact on morphine administered to infants post cardiac surgery, and whether any differences observed would be amplified within the Trisomy 21 population.MethodologyA retrospective single centre before/after study design was used. Patients aged between 44 weeks postconceptual age and one year old who had open cardiothoracic surgery were included.Results61 patients before and 64 patients after the intervention were included. After the intervention, a reduction in the amount of morphine administered was not evident, while greater use of adjuvant sedatives and analgesics was observed. Patients with Trisomy 21 had a shorter duration of mechanical ventilation after the change in practice.ConclusionThe findings from this study affirm the importance of the nurses' role in managing prescribed analgesia and sedation supported by best available evidence. A continued education and awareness focus on analgesia and sedation management in the pursuit of best patient care is imperative.Copyright © 2020 Elsevier Ltd. All rights reserved.

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