is an Assistant Professor of Nurse Anesthesia at Columbia University School of Nursing, New York, New York; and a CRNA Managing Partner at Modern Anesthesia Care Solutions, PLLC, Oxford, Connecticut. Email:
is Clinical Professor and Director of the DNP Program, University of Connecticut, Storrs, Connecticut. Email:
AANA J. 2024 Apr;92(2):145-152.
Certified registered nurse anesthetists (CRNAs) who are responsible for airway management, may lack adequate continuing education for emergency front of neck access (EFONA), an advanced skill necessary in situations when a patient cannot be intubated and cannot be oxygenated (CICO). The purpose of this study was to improve CRNA knowledge and confidence when performing a scalpel-bougie cricothyrotomy for EFONA in a CICO event through the implementation of a spaced learning intervention. Thirteen CRNAs at a 160-bed community hospital participated in a 3-week educational intervention. Week 1: online preintervention survey followed by an educational video. Week 2: video review and skills component practiced on a cricothyrotomy trainer. Week 3: skills component practiced on a cricothyrotomy trainer followed by postintervention survey. This was a single-arm study and Wilcoxon sign ranked tests and a paired t-test were utilized to monitor for change in CRNA knowledge, confidence, and skill in performing EFONA. Implementation of a 3-week spaced learning program for educating CRNAs to perform a scalpel-bougie cricothyrotomy significantly increased CRNA knowledge, confidence, and skill when performing EFONA. Utilizing a spaced learning program may therefore improve provider skills, resulting in optimized patient care during a CICO event, leading to improved patient safety and outcomes.
负责气道管理的注册护士麻醉师(CRNAs)可能缺乏紧急前颈部通路(EFONA)的足够继续教育,这是在患者无法插管和无法供氧(CICO)的情况下所需的高级技能。本研究的目的是通过实施间隔学习干预来提高 CRNA 在 CICO 事件中进行刀片-探条环甲切开术以进行 EFONA 的知识和信心。在一家 160 张床位的社区医院的 13 名 CRNAs 参加了为期 3 周的教育干预。第 1 周:在线预干预调查,然后是教育视频。第 2 周:视频复习和在环甲切开训练器上进行技能部分练习。第 3 周:在环甲切开训练器上进行技能部分练习,然后进行干预后调查。这是一项单臂研究,采用 Wilcoxon 符号秩检验和配对 t 检验来监测 CRNA 进行 EFONA 的知识、信心和技能的变化。实施为期 3 周的间隔学习计划,教育 CRNAs 进行刀片-探条环甲切开术,可显著提高 CRNA 进行 EFONA 的知识、信心和技能。因此,利用间隔学习计划可以提高提供者的技能,从而在 CICO 事件期间优化患者护理,提高患者安全性和结果。