Joseph Glahn, RN, DNP, CRNA

Joseph Glahn, RN, DNP, CRNA

DNP Nurse Anesthesia

Evaluating the Effectiveness of Preoperative Education on Medication Compliance at a Midwest Hospital Surgery Center

Project Category:  Original Research 

Project Team: Joseph Glahn, DNP, CRNA, Jason Besse, DNP, CRNA 

Abstract

Background: The use of angiotensin receptor blockers (ARBs) or angiotensin-II inhibitors (ACE-I) prior to anesthesia can impact the perioperative course by inducing intraoperative hypotension resulting in inadequate perfusion, or even death, if left untreated. While many hospitals instruct patients to withhold these antihypertensives prior to surgery or anesthesia, communication is often insufficient to ensure patient compliance. The project aimed to improve staff knowledge levels, enhance patient recall of information, and increase patient compliance with preoperative antihypertensive medication instructions.

Methods: The principal researchers collaborated with a community hospital surgery center to develop an evidence-based consensus-validated preoperative medication instruction guide for patients. Education was provided to perioperative nurses through in-person presentation and PowerPoint. Sampling methods included non-random non-probability quota sampling with 25 males and 25 females in both pre- and post-intervention groups. All participants were prescribed an angiotensin converting enzyme-inhibitor (ACE-I) or angiotensin receptor blocker (ARB).

Results: 6/6 (100%) of the full-time perioperative nurses of staff were trained on the medication compliance tool prior to implementation. Patient ACE-I and ARB preoperative compliance rates improved from 34% (17/50) pre-implementation, to 76% (38/50) post-implementation (Chi square value=17.1, p < 0.01).

Conclusion: A compliance tool and/or staff education may be effective for mitigating patients’inadvertent use of ACE-I and ARB the morning of surgery. Further investigation is needed to determine if consistent use of the tool could impact longer-term patient outcomes.

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