Elyse Kalil, RN, DNP, CRNA

DNP Nurse Anesthesia Evidence Implementation

Evidence-Based Webinar on Neuromuscular Monitoring and Reversal Strategies

Project Category: Evidence Implementation

Project Team: Elyse Kalil, DNP, CRNA Mahi Nagar, DNP, CRNA, Katelyn Rapacchietta, Jennifer Greenwood, PhD, CRNA (Advisor)

Abstract

Background:  Neuromuscular blocking agents (NMBAs) are frequently used by anesthesia providers to facilitate intubation and ensure optimal surgical conditions by rendering the skeletal muscles immobile. The use of quantitative neuromuscular monitoring and reversal agents allows for a safe recovery from a paralyzed state, facilitating emergence from anesthesia. Recent research demonstrates that anesthesia providers may be deficient in knowledge regarding neuromuscular monitoring and reversal agents. Therefore, an evidenced-based online learning module was created to provide best practice updates for anesthesia providers and measure their knowledge on this important topic.

Methods: Participants were recruited using social media which directed them to a web-based platform to complete a 60-minute educational module. A pre and post knowledge assessment was performed. Questions assessed knowledge on proper dosing, monitoring, and mechanism of action for neuromuscular blocking agents.

Results: A total of 23 anesthesia providers completed the educational module and the additional survey questions in their entirety. A total of 75% (N=15) of participants reported using qualitative monitoring as their primary monitoring device, while only 20% (N=4) reported using quantitative monitoring in the demographic survey questions. The accuracy of reversal drug dosage calculations improved from 66% in the pre-test to 89.13% correct in the post-test. The overall assessment average for all questions also improved from 68.6% to 79.69% (p=0.045).

Conclusion: Study results suggest that a knowledge deficit regarding proper reversal strategies and monitoring for neuromuscular blockades exist amongst anesthesia providers. Additionally, most participants rely on qualitative monitoring to guide neuromuscular reversal strategies in practice. Findings of this project suggest that an educational module regarding neuromuscular blockade and monitoring may be effective in increasing anesthesia providers’ knowledge for emerging practice trends as evidenced by the improved post-test scores.

Full Manuscript Slide Presentation Video