Knowledge, Attitudes, and Practices of Sedation in Pediatric Intensive Care Unit among consultants/fellow and Residents at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2025.

Abstract

Summary Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted to PICU. Sedation is often necessary to maintain optimal care for critically ill children requiring Mechanical ventilation. However, if sedation is too deep or too light it has its own adverse effects, and hence it is important to monitor level of sedation and maintain an optimal level. Objectives: To assess Knowledge, Attitudes, and Practices of sedation among Pediatric Intensive Care Unit consultant/fellow and Residents at St. Paul’s Hospital Millennium Medical College Addis Ababa, Ethiopia, From September 2025 to November 2025. Methods: Institutional based cross-sectional study was conducted in the PICU of SPHMMC from September 2025 to November 2025. All PICU consultants/fellow and residents were included in the study. Hence, the sample size was equal to the study population which was 188. The convenience sampling method was used to include all eligible consultants/fellow and residents working in the PICU. The data was collected by standardized pretested questionnaire. Descriptive statistical analysis, to see the association between independent variables and outcome variables binary logistic regression was used. Independent variables with a p-value of < 0.25 at 95% CI in bi-variable analysis were retained for multivariable logistic regression analysis. Variables with a P-value ≤ 0.05 were declared as statistically significant. Results: A total of 188 questionnaires were distributed, of which 180 were fully filled out and collected back making the response rate 95.7%. About 62.8% of the respondents scored above the mean knowledge score. Consultants/fellow and Residents who didn’t get married were 65.1% (AOR = 0.349; CI = 0.156–0.78) less likely to have adequate knowledge than those who did get married. Being R1 and R2 were 94.1% (AOR = .059; CI = 0.020-0.179) and 67.6% (AOR=.324; CI=.135-.779) less likely knowledgeable than those consultants/fellow and Residents who were R3 respectively. 52.7% of consultants/fellow and Residents had good practice and 46.7% of consultants/fellow and Residents had unfavorable attitude towards pediatric pain management. Conclusion and Recommendation: This study showed that while many PICU consultants and residents had reasonable knowledge about pediatric sedation, important gaps remain in everyday practice and attitude. The use of standardized sedation assessment tools and routine documentation was inconsistent, suggesting a gap between what clinicians know and what is consistently applied at the bedside. Differences in training level and experience influenced knowledge and practice. Overall, sedation management in the PICU is variable and not yet fully aligned with evidence-based standards. Based on this study the proposed recommendation should rely on Focused training, implementation of a clear written sedation protocol, and routine use of validated assessment tools should be prioritized to improve consistency and patient safety. Ongoing quality improvement efforts and regular reinforcement during clinical rounds are essential to strengthen sedation practice and ensure better outcomes for critically ill children. Key words: Sedation, Pediatric intensive care unit, Knowledge, Attitudes, and Practices.