Education on Lung Protective Ventilation and Anesthesia Provider Perception in the Intraoperative Period

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)

Anna Ruse (Creator)

Institution

The University of North Carolina at Greensboro (UNCG )

Web Site: http://library.uncg.edu/

Advisor

Terry Wicks

Abstract: Background: Post-operative pulmonary complications (PPCs) are one of the leading causes of morbidity and mortality during the postoperative period. These complications add over $3.5 billion annually to the healthcare system. With induction of general anesthesia and alveoli collapse, causing atelectasis in about 90% of patients. When atelectasis occurs, it increases the risk of PPCs. Atelectasis and PPCs can be reduced using the lung-protective ventilation (LPV) strategy. The LPV strategy incorporates low tidal volumes, positive end-expiratory pressure (PEEP), alveolar recruitment maneuvers, and lower driving pressures. Purpose: This DNP project aims to educate anesthesia providers on the benefits of lung protective ventilation and increase its utilization in the intra-operative period. There is a wide variation in how anesthesia providers ventilate their patients. This project aims to promote the adoption of lung protective ventilation techniques by providing education emphasizing current evidence-based best practices. Methods: A pre and post-intervention survey will be administered to the providers. After the pre-intervention survey, an educational in-service will be provided, detailing current research supporting LPV and practice recommendations. A “badge buddy” will be handed out to the anesthesia staff at the hospital which will focus on the crucial elements of Lung Protective Ventilation. Four weeks later a post-intervention survey will be administered to determine if practice change occurred. Results: The McNemar test assessed two questions of binary paired data. The first question assessing LPV use in the intra-operative period accepted the null hypothesis. The second question examined whether providers assessed driving pressures in the intra-operative period. The data on this question rejected the null hypothesis. Qualitative analysis was used to analyze the remaining data collected through the survives. Recommendations and Conclusions: Many providers already implemented elements of LPV in current practice. However, more research needs to be conducted to determine the optimal level of PEEP. Anesthesia providers and facilities should continue to prioritize the use of LPV to help minimize PPCs.

Education on Lung Protective Ventilation and Anesthesia Provider Perception in the Intraoperative Period
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Created on 6/25/2024
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Additional Information

Publication

Other

Language: English

Date: 2024

Keywords

Lung protective ventilation, LPV, driving pressures, post-operative pulmonary complications, alveolar recruitment maneuvers, recruitment maneuvers, vital capacity breath, atelectasis, positive end-expiratory pressure, PEEP

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