Ultrasound-guided Regional Anesthesia Training for Rural CRNAs

Lee Webber, RN, DNP, CRNA

DNP Nurse Anesthesia

Ultrasound-guided Regional Anesthesia Training for Rural CRNAs

Project Category:  EBP

Project Team: Lee Webber, DNP, CRNA , DNP, CRNA Jennifer Greenwood, CRNA, PhD (Advisor)

Abstract

Background: The use of peripheral nerve blocks in the prevention and control of postoperative acute pain is of extreme importance. The significance of this modality in decreasing the use of perioperative narcotics, postoperative nausea and vomiting, and length of stay while improving overall pain control and increasing patient satisfaction cannot be overstated. However, the availability of training and mentorship for anesthesia providers in rural areas is particularly challenging. Barriers include geographic distance from training, little time off, professional coverage while away, and provider confidence in administering peripheral nerve blocks after a single training.  To address these barriers, evidence-based quality improvement project was implemented which aimed to improve access to training by bringing it on site, and to increase clinician confidence in performing peripheral nerve blocks by focusing only on those applicable to their specific clinical site and surgical populations.

Methods: Ultrasound-guided peripheral nerve block training was performed at three rural clinical sites in different states. Pre- and post-implementation questionnaires were completed measuring clinician perception and confidence levels related to ultrasound-guided peripheral nerve block practices.

Results: Positive trends were noted in all areas of perception of regional anesthesia, confidence with obtaining consent and performing blocks, and competence with the various techniques.

Conclusion: While sample size was too small to determine statistical significance, a tailored, mobile training program is a viable format for reaching anesthesia providers in rural areas to increase the number of blocks performed and improve patient outcomes in those areas.

Full Manuscript Slide Presentation Video