Validity and reliability of the Niño Jesús Hospital procedural sedation scale under deep sedation-analgesia

Lozano-Díaz, David; Serna, A. Valdivielso; Palomo, Ramón Garrido; Arias, Ángel; López, Pedro Juan Tárraga; Gutiérrez, Andrés Martínez

doi:10.1016/j.anpede.2020.04.016

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“…These assessors scored 150 videos according to the UMSS. As this work was also used for the validation of the Niño Jesús Hospital Procedural Sedation Scale 13,14 , to avoid the same evaluators possibly introducing bias when scoring the same videos with the RS and NJHPSS, a crossover design was used: Five weeks after scoring the videos, the pediatrician and the PICU nurse (group 1 A) scored the 150 randomized videos (videos 1) using the RS. The anesthetist and the OR nurse (group 1 B) scored the other 75 videos (videos 2) with the RS.…”

Section: Methodsmentioning

confidence: 99%

Validation of the Ramsay scale for invasive procedures under deep sedation in pediatrics

Lozano-Díaz

Serna

Palomo

et al. 2021

Pediatric Anesthesia

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Background:The Ramsay scale is the most widely used scale during pediatric procedures although it has not been formally validated.Objective: To validate the Ramsay scale during invasive procedures under sedation in pediatrics.Methods: A prospective analytic study was conducted in two hospitals. All patients ≥6 months that were undergoing invasive procedures under sedation were enrolled.All were recorded, and these videos were edited and randomized. 150 videos were scored by four observers (a pediatrician, a pediatric intensive care unit nurse, an anesthetist, and an operating room nurse). All videos were scored with the Ramsay scale and University of Michigan Sedation Scale. Observers were blinded to drug administration. Construct validity was measured through Wilcoxon test paired samples after administration of sedatives. Criterion validity, intra-observer reliability, and interobserver correlation were evaluated by comparing the scores of the scales using Spearman's correlation coefficient. Interobserver agreement was measured using the intraclass correlation coefficient. To assess test-retest reliability, 50 videos were randomly selected and reevaluated.Results: Sixty-five patients were included. Construct validity was demonstrated through changes in the Ramsay scale scoring after administration of sedatives (p < .0001). Regarding criterion validity, the Ramsay scale had a high correlation with the UMSS (ρ = 0.621). Intra-observer agreement was ρ = 0.884. The Ramsay scale showed interobserver reliability with an intraclass correlation coefficient = 0.94 when comparing it with the University of Michigan Sedation Scale. Internal consistency was α = 0.91. Regarding applicability, in our study, it was applied in two hospitals in different areas by four professionals from distinct categories. Conclusions:The Ramsay scale is valid, reliable, and applicable to monitoring sedation for invasive procedures under deep sedation in pediatrics.

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Section: Methodsmentioning

confidence: 99%