Educational Strategies to Improve Knowledge Retention and Clinical Competency in the Management of Local Anesthetic Systemic Toxicity: An Integrative Review.

Background: Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication of anesthetic administration. Nurses are often the first to observe subtle signs of toxicity, yet studies show gaps in knowledge and preparedness. This integrative review was conducted to evaluate effec...

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Publicado en:Journal of Continuing Education in Nursing Vol. 57; no. 7; pp. 305 - 317
Autores principales: Adams, Hannah G., Silab, Sensei Kin Mariae Y., Halstead, Alexander E.
Formato: review tables/charts Journal Article
Publicado: SLACK Incorporated Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of Continuing Education in Nursing
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      dt: Jul2026
      vid: 57
      iid: 7
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      pub: SLACK Incorporated
      place: Thorofare, New Jersey
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        10.3928/00220124-20260407-02
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        atl: Educational Strategies to Improve Knowledge Retention and Clinical Competency in the Management of Local Anesthetic Systemic Toxicity: An Integrative Review.
      aug:
        au:
          Adams, Hannah G.
          Silab, Sensei Kin Mariae Y.
          Halstead, Alexander E.
        affil: Johns Hopkins University School of Nursing, Baltimore, Maryland.
      sug:
        subj:
          Perioperative Nursing Education
          Education, Nursing, Continuing
          Anesthetics, Local Adverse Effects
          Drug Toxicity Education
          Patient Safety Education
          Perioperative Nurses
          Students, Nursing, Baccalaureate
          Teaching Methods
          Nursing Knowledge Evaluation
          Student Knowledge Evaluation
          Clinical Competence
          Competency Assessment
          Certified Registered Nurse Anesthetists
          Health Personnel
          Online Education
          Computer Simulation
          Patient Simulation
          Computer-Assisted Instruction
          Lecture
          Posters
          Confidence
      ab: Background: Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication of anesthetic administration. Nurses are often the first to observe subtle signs of toxicity, yet studies show gaps in knowledge and preparedness. This integrative review was conducted to evaluate effective educational strategies for clinicians to identify and manage LAST in the clinical setting. Method: A total of 13 articles were selected for inclusion based on their relevance to LAST education. Results: Thirteen studies met the inclusion criteria. Four primary educational strategies were identified: didactic instruction, simulation-based learning, web-based modules, and cognitive aids. All modalities showed significant short-term improvement in knowledge. Combined approaches, particularly simulation with didactic instruction, showed the strongest outcomes. Knowledge decay was identified as a persistent challenge, with only five studies assessing retention beyond 3 months. Conclusion: Preparing nurses and students for LAST requires integrated strategies that combine accessible content with experiential practice. Future research should emphasize long-term knowledge retention and innovative modalities to strengthen LAST education.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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