Testing the Reliability and Validity of the CIBA

Study Overview
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Brief Summary
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The overall objective of the study is to improve the experience for pediatric patients undergoing anesthesia inductions. The specific objective for this proposal is to establish whether the CIBA tool demonstrates inter-rater reliability and concurrent validity with the Induction Compliance Checklist.

Detailed Description
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The proposed research study will assess the reliability and validity of a new tool that is being used in the Department of Anesthesia (The Child Induction Behavioral Assessment tool) to grade the difficulty of patient behaviors exhibited during anesthesia inductions. The Child Induction Behavioral Assessment (CIBA) tool is more succinct than previously validated tools for assessing behavioral responses to inhalation inductions, making it practical for use in a busy clinical practice setting. Having clinicians document a patient's behavioral response to induction using the CIBA tool is useful because this information can help to optimize subsequent induction plans if the patient returns. Additionally, population data may be collected using electronic data reports for QI purposes. Prior to using data from the CIBA tool in QI initiatives, it is important to assess whether this tool is reliable and valid.

Conditions
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Quality Improvement

Intervention / Treatment
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* Behavioral: Observing patient behaviors for anesthesia induction compliance


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Presenting to Same Day Surgery department at CCHMC base campus for any surgical or Intervention Radiology procedure Ages 1-13 years old Male or female Patients of any ethnicity Family and participant communicate primarily in English Patients with normal neurocognitive development Patients undergoing inhalation induction using an anesthesia mask American Society of Anesthesiologists (ASA) physical classification status I, II, or III Patients who do or do not receive a premedication for anxiety Parent/guardian present at the induction of anesthesia Exclusion Criteria: Guardian unavailable to give consent Neurocognitive delays Tracheostomy Intravenous (IV) induction or nitrous sedation prior to IV induction Coordinators unable to observe or fully observe the induction CIBA assessment not completed by anesthesia provider

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CIBA Study Cohort<br>Patients aged 1 to 13 years undergoing inhalation inductions for general anesthesia | Behavioral: Observing patient behaviors for anesthesia induction compliance<br>* Observing patient behaviors for anesthesia induction compliance so to test reliability and validity of the CIBA Tool<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Test the reliability and validity of the Child Induction Behavioral Assessment (CIBA) Tool by evaluating inter-rater reliability and concurrent reliability and validity of the CIBA tool with the already validated Induction Compliance Checklist (ICC) |  | two years |