Confidence in Implementing Lung Protective Ventilation Guidelines Among Certified Registered Nurse Anesthetists
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Tyler Garrett (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Joshua Borders
Abstract: Background: Although lung protective ventilation (LPV) guidelines have been established, applying appropriate Positive End-Expiratory Pressure (PEEP) and Alveolar Recruitment Maneuvers (ARMs) varies among anesthesia providers. Ventilating obese patients undergoing laparoscopic surgery poses even more difficulty with ventilation due to the combination of excess fat tissue and abdominal insufflation. Therefore, it is important to understand how to apply PEEP and know when to perform ARMs to optimize ventilation in this patient population.Purpose: The purpose of this project was to examine Certified Registered Nurse Anesthetist’s (CRNAs) knowledge and confidence in implementing LPV strategies in obese adults having laparoscopic surgery.Methods: A quantitative design, involving the development of a pre and post questionnaire, was distributed among the participants involved in this study. Participating CRNAs were given a questionnaire related to their use of lung protective ventilation. The questionnaire contained domains such as knowledge, confidence, and utilization. Following the initial questionnaire, an educational session was performed by the researchers regarding lung protective ventilation techniques. Participating CRNAs were then instructed to complete the same questionnaire following the education session. The pre and post surveys were paired, and data was analyzed after conducting a paired T-test performed to obtain our results. Data was displayed via charts and graphs. Results: The total number of participants involved in this study was 17, with all participants responding to the pre and post education survey. After our education, the results showed a 18% increase in confidence when choosing individualized PEEP for laparoscopic obese patients and a 13% increase in confidence when ventilating patients with a BMI > 55. In addition, there was a 12% increase in confidence when applying alveolar recruitment maneuvers, and a 11% increase in participants utilizing LPV strategies in their practice. However, our results indicated p-values > 0.05, which demonstrated our intervention did not statistically influence the mean scores of confidence among CRNAs. Conclusion: The results showed that almost all participating CRNAs had improvement in confidence after education when applying LPV strategies to obese laparoscopic patients. However, our data demonstrated our interventions did not significantly impact overall CRNA confidence in implementing LPV strategies in obese laparoscopic patients. Although the literature still varies on LPV strategies, we recommend utilizing our educational interventions to promote further increases in knowledge and confidence. In addition, we recommend further investigations to help establish a standard LPV evidence-based practice guideline for laparoscopic obese patients.
Confidence in Implementing Lung Protective Ventilation Guidelines Among Certified Registered Nurse Anesthetists
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Created on 6/20/2024
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Additional Information
- Publication
- Other
- Language: English
- Date: 2023
- Keywords
- Lung Protective Ventilation, Certified Registered Nurse Anesthetists, Alveolar Recruitment Maneuvers, Positive-end-expiratory pressure