Assessment of knowledge and practice on sedation outside the operating theaters at Muhimbili National Hospital, Dar es salaam, Tanzania, 2016

Abstract

Background: Sedation is the administration of sedatives to the patients planned for diagnostic and therapeutic procedures so as to reduce anxiety and fear. Most of the sedation providers are non-anesthesiologists. Sedation is supposed to be given by experienced and skilled personnel to avoid complications. Proper monitoring during the sedation procedure will make the practice efficiently, detect the complications and be able to manage the complications. Involvement of anesthesiologists and the use of trained non anesthesiologist doctors can lead into the better practice of sedation. The aim of the study: The aim of the study was to assess providers’ knowledge, and practice towards sedation outside the operating theater at MNH from May to July 2016. Methodology: This was a hospital based descriptive cross sectional study which was done at MNH in the departments of Emergency medicine, Radiology (CT-scan and MRI), Psychiatry, Gastroenterology, Emergency department, and Dental unit. The study population was 110 sedation practitioners outside operating theaters. The information obtained was providers’ age, sex, experience, duration of the practice, pre-sedation assessment form, completion of data monitoring form, use of protocol, monitoring during sedation, use of oxygen, use of assistant, use of resuscitation equipment, training in resuscitation, training in sedation, knowledge on pharmacology of drugs, type of the drugs used and route of administration and complications was obtained by an interview with eligible consented sedation providers using a modified standard questionnaire adopted by Fanning. Data were entered and analyzed using SPSS version 20. Results: Nineteen percent of the study participants had high knowledge on pharmacology of the drugs. Approximately, 34.5% of the study participants used protocol for sedation, 18% did pre- sedation assessment of patients and 9.1% used monitoring data form during sedation. About thirty three percentage used oxygen during sedation while 35.5% had completed ACLS with only 31% of them had valid certificates. Fewer study participants (15.5%) underwent formal training prior to using sedation. Monitoring technique was poor and none used ETCO2. Diazepam was found to be the most commonly used sedative. Intravenous route was used by most study participants (45.5%). Conclusion: Despite providing sedation outside the operating theaters, majority of the sedation providers had poor knowledge and practice.