Increasing staff comfort in performing conscious sedation during brachytherapy : a teaching quality improvement project

Problem: The current practice of oral anxiolytics for patients undergoing brachytherapy within a specific cancer center (CC) has had inadequate outcomes for pain control and anxiety. The CC decided to transition to intravenous sedation; however, there was concern from the nursing staff regarding patient safety, due to the lack of hands-on experience administering these new medications. Purpose: The goal of this quality improvement project was to provide a formal instructional experience that increased the department's collective confidence level on providing IV sedation, while answering the question: "Does the implementation of a conscious sedation workshop, along with providing new airway equipment, increase the confidence of radiation oncology nursing staff while performing brachytherapy?" Methods: The intervention proposed was to provide a lecture and simulation workshop for the CC staff. This took place in small groups in the actual procedure room. Topics covered include sedation medications, reversal agents, rescue equipment, and end-tidal carbon dioxide (EtCO2) monitoring. Workshop efficacy was measured by comparing pre- and post-workshop reported comfort levels of the providers via survey. Results: Post-intervention survey results show an overall increase in comfort levels from 29% to 67%, with the largest improvement being in sedation dosages and their reversal agents. A topic of further teaching is EtCO2, which only has 50% comfort (up from 15%). Conclusions: This project reinforced an existing IV sedation policy, as well as created new guidelines for the specific brachytherapy procedure. The lecture and workshop increased department comfort but still has room for improvement in some topics. Overall, the process created a new formal pre-operative checklist, presence of an emergency supply kit, reversal agents on pharmacy formulary, and implemented a new policy on crash cart locations within the CC.

Author dc:creator

• Esper, Ethan E. (Ethan Edward)

Contributors dc:contributor

• Crane, Patrick

• Conscious sedation
• Intravenous anesthesia
• Medical personnel--In-service training
• Medical personnel--Psychology
• Confidence
• Anesthesia in oncology

Statement dc:rights

• In Copyright

Language dc:language

English

Identifier

dnp:87
oclc:1570815653
local:R_7mV1pAwlyfjEt96

OAI identifier oai:identifier

oai:d.lib.msu.edu:dnp_87