Residual Neuromuscular Blockade in the Post Anesthesia Care Unit: An Educational Initiative
Abstract
Background or Problem/Issue: The nationwide occurrence of RNMB is approximated to be 30% (Esteves, et al., 2013). Although currently not tracked, this equates to a rate of roughly 3,000 cases at NMC Portsmouth annually. There is no formal education for recognition and treatment of RNMB for PACU nurses, which can lead to delayed or inaccurate diagnosis. The nurse or corpsman are may be the initial PACU staff to identify RNMB. Clinical Question or Purpose: At NMC Portsmouth, does an educational video for PACU nurses and corpsmen increaseawareness, recognition, and management of RNMB? Project Design: The design of this project is a quality improvement project using Lippitts change theory. PACU nurses and corpsmen at NMCP were provided a 10-question pre-assessment, including demographic information. A 17-minute educational video was shown to participants. At the conclusion of the video the same 10-quesiton test was administered with two additional questions using a Likert scale evaluating overall confidence in recognizing and managing RNMB. Data Analysis: The Wilcoxon Signed Rank test found significance when overall pre- and post-assessment scores were compared, p<0.001, and showed an increase in post-assessment of 44%. Post video Likert scale: 87.5% strongly agreed or agreed to an increase in ability to recognize RNMB. 81% strongly agreed or agreed to an increase in ability to assess and treat RNMB in the future. Organizational Impact/Implications for Practice: Currently, there is no information on RNMB in NMC Portsmouth PACU orientation, in SWANK, or in Elsevier Clinical Skills. The educational video fills a gap in military nursing and support staff caring for patients in the PACU. The anticipated global impact is to increase knowledge, recognition, and management of RNMB in Navy MTFs and DoD-wide, leading to decreased costs, decreased morbidity and mortality, improved nurse and corpsman training and readiness, and improved patient safety.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 30, 2019
- Accession Number
- AD1127749
Entities
People
- Alisen Rockwell
- Brandi Alford
- Jonathan Mcgowen
Organizations
- Uniformed Services University of the Health Sciences