Local Anesthetic Systemic Toxicity: Ensuring Sustained Nursing Knowledge in a High-Volume Outpatient Surgery Center.

Local anesthetic systemic toxicity (LAST) is a low-frequency, high-risk event that can occur within minutes of a patient receiving a local anesthetic. The goals of this project were to standardize LAST care management across an academic medical center and sustain an improvement in nurses' knowledge...

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Publicado en:Journal of PeriAnesthesia Nursing Vol. 39; no. 5; pp. 722 - 729
Autores principales: White, Alicia, Rougeau, Cia, Gilbert, Tabatha, Hughes, Elaine
Formato: research Journal Article
Publicado: W B Saunders Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2024
      vid: 39
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      pub: W B Saunders
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        10.1016/j.jopan.2023.12.007
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        atl: Local Anesthetic Systemic Toxicity: Ensuring Sustained Nursing Knowledge in a High-Volume Outpatient Surgery Center.
      aug:
        au:
          White, Alicia
          Rougeau, Cia
          Gilbert, Tabatha
          Hughes, Elaine
        affil: Outpatient Surgery Center, UVA Health, Charlottesville, VA
      sug:
        subj:
          Anesthetics, Local Adverse Effects
          Drug Toxicity
          Nursing Knowledge
          Academic Medical Centers
          Surgicenters
          Human
          Female
          Male
          Quantitative Studies
          Multidisciplinary Care Team
          Practice Guidelines
          Checklists
          Simulations
          Clinical Competence
          Descriptive Statistics
          Female
          Male
      ab: Local anesthetic systemic toxicity (LAST) is a low-frequency, high-risk event that can occur within minutes of a patient receiving a local anesthetic. The goals of this project were to standardize LAST care management across an academic medical center and sustain an improvement in nurses' knowledge of how to recognize signs and symptoms of LAST and how to competently manage a LAST scenario. We used a quantitative design to accomplish the goals of the project. Our interdisciplinary team developed a clinical practice guideline based on the LAST Checklist published by the American Society of Regional Anesthesia and Pain Medicine, and used a simulation scaffolded by multimodal education and system changes to ensure sustained knowledge. We measured improvement using a graded knowledge assessment as well as qualitative feedback. Scores on the assessment increased from 4.76 to 6.34 (out of seven points) following the intervention and remained significantly higher than the baseline 9 months after the educational intervention (9-month score = 6.19, t = 2.99, P =.004). Nurses reported feeling more confident and knowledgeable following the intervention and requested to have regular sessions of the simulation. To sustain improvements, we developed a computer-based learning module. The module and simulation were integrated into nursing orientation and an annual competency. While standardizing LAST care in accordance with evidence-based guidance is critical to patient safety due to its infrequent occurrence, nurses should consider implementing simulation supplemented with multimodal education and system changes to ensure sustained knowledge.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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