O'Driscoll Lisa, Girolamo Robert G, Crerar Christopher, Williamson Walter, Moore Chad, Wofford Kenneth, Bonds Raymond
principle investigator at the Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Uniformed Services University of the Health Sciences, Bethesda, Maryland.
AANA J. 2018 Dec;86(6):479-487.
Anesthesia practitioners at the authors' facility had varying education and training with placing transversus abdominis plane (TAP) blocks and with the use of liposomal bupivacaine limiting the utilization of this regional anesthetic technique for patients undergoing abdominal surgical procedures. An expansive literature review suggested that ultrasound-guided liposomal bupivacaine TAP blocks were safe and effective for reducing postoperative pain scores, opioid use, and no reported adverse effects. Current literature findings were used to craft an educational intervention to update current practices among anesthesia practitioners. The purpose of the project was to develop and implement an educational intervention to improve the knowledge and confidence of all anesthesia providers at our facility when placing and managing liposomal bupivacaine TAP blocks in patients undergoing abdominal surgery. We used the Ajzen Theory of Planned Behavior to create an effective practice change, combined with skill acquisition through simulation, among anesthesia providers at our facility in performing ultrasound-guided liposomal bupivacaine TAP blocks. The implementation of a multistrategy education program using simulation resulted in a significant increase in knowledge and confidence among anesthesia practitioners.
在作者所在机构,麻醉医生在放置腹横肌平面(TAP)阻滞以及使用脂质体布比卡因方面接受的教育和培训各不相同,这限制了该区域麻醉技术在接受腹部外科手术患者中的应用。广泛的文献综述表明,超声引导下脂质体布比卡因TAP阻滞对于降低术后疼痛评分、减少阿片类药物使用是安全有效的,且未报告有不良反应。当前的文献研究结果被用于制定一项教育干预措施,以更新麻醉医生的现有操作。该项目的目的是开发并实施一项教育干预措施,以提高我们机构所有麻醉医生在为接受腹部手术的患者放置和管理脂质体布比卡因TAP阻滞时的知识水平和信心。我们运用艾森计划行为理论,在我们机构的麻醉医生中,通过模拟进行技能获取,从而实现有效的实践改变,以实施超声引导下脂质体布比卡因TAP阻滞。使用模拟的多策略教育项目的实施,使麻醉医生的知识水平和信心显著提高。