Skip to main content
main-content

01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Palliative Care 1/2014

The Richmond Agitation-Sedation Scale modified for palliative care inpatients (RASS-PAL): a pilot study exploring validity and feasibility in clinical practice

Zeitschrift:
BMC Palliative Care > Ausgabe 1/2014
Autoren:
Shirley H Bush, Pamela A Grassau, Michelle N Yarmo, Tinghua Zhang, Samantha J Zinkie, José L Pereira
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-684X-13-17) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SB participated in the design of the study, performed the qualitative statistical analysis and drafted the manuscript. PG participated in the qualitative statistical analysis, the interpretation of this data and helped to draft the manuscript. MY conducted participant interviews, participated in the study coordination and performed the qualitative statistical analysis. TZ performed the quantitative statistical analysis. SZ conducted participant interviews and participated in the study coordination. JP conceived of the study, and participated in its design and helped to draft the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The Richmond Agitation-Sedation Scale (RASS), which assesses level of sedation and agitation, is a simple observational instrument which was developed and validated for the intensive care setting. Although used and recommended in palliative care settings, further validation is required in this patient population. The aim of this study was to explore the validity and feasibility of a version of the RASS modified for palliative care populations (RASS-PAL).

Methods

A prospective study, using a mixed methods approach, was conducted. Thirteen health care professionals (physicians and nurses) working in an acute palliative care unit assessed ten consecutive patients with an agitated delirium or receiving palliative sedation. Patients were assessed at five designated time points using the RASS-PAL. Health care professionals completed a short survey and data from semi-structured interviews was analyzed using thematic analysis.

Results

The inter-rater intraclass correlation coefficient range of the RASS-PAL was 0.84 to 0.98 for the five time points. Professionals agreed that the tool was useful for assessing sedation and was easy to use. Its role in monitoring delirium however was deemed problematic. Professionals felt that it may assist interprofessional communication. The need for formal education on why and how to use the instrument was highlighted.

Conclusion

This study provides preliminary validity evidence for the use of the RASS-PAL by physicians and nurses working in a palliative care unit, specifically for assessing sedation and agitation levels in the management of palliative sedation. Further validity evidence should be sought, particularly in the context of assessing delirium.
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2014

BMC Palliative Care 1/2014 Zur Ausgabe

Neu im Fachgebiet AINS

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update AINS und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise