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Acquisition and Retention of Knowledge and Skills by Operating Room Nurses in Providing Anesthetic Assistance during Emergency Cesarean Delivery under General Anesthesia
Abstract Number: T2C-262
Abstract Type: Original Research
Introduction: During emergency cesarean delivery, an anesthesiologist often needs additional assistance from operating room nurses (ORN) to safely induce general anesthesia (GA). This role requires specific knowledge and skills; however, due to low institutional rates of GA cesarean deliveries, ORN may not be comfortable providing assistance. Consequently, we developed and administered a 30-min structured training program (STP) to all ORN. We hypothesized there would be significant improvement in knowledge and skills following STP, and that these would be retained at 6 weeks and 6 months.
Methods: Following ethical approval for waiver of consent, 42 ORN at our institution were invited to participate. First, in groups of 2 to 3 participants, baseline knowledge was assessed using a 14-item paper multiple choice questionnaire (MCQ); skills were assessed using a 12-item checklist scored by direct observation during simulated induction of GA. Next, a 20-min didactic lecture followed by a 10-min hands-on skills station were delivered. Finally, knowledge and skills were immediately re-assessed after STP, and again at 6 weeks and 6 months. Topics covered in STP included intraoperative monitors, airway equipment, patient positioning, pre-oxygenation and rapid sequence intubation. Primary outcome was knowledge and skills retention measured by change in mean MCQ and checklist scores at 6 weeks and 6 months analyzed by independent samples t-test. Secondary outcome was knowledge and skill acquisition after STP. P-values were adjusted for multiple comparisons.
Results: To date, data were collected for 35 ORN up to 6 weeks. Compared to baseline, there was a significant increase in both mean MCQ (84.7% vs. 63.7%, p<0.0001) and checklist scores (86.3% vs. 46.3%, p<0.0001) immediately post-STP.(Fig) At 6 weeks, mean MCQ score remained stable but a significant decay in mean checklist score was found (86.3% vs. 81.4%, p=0.018).
Discussion: The knowledge and skills in providing anesthetic assistance by ORN were low at baseline; however, significant improvement occurred following a STP. Consistent with findings in the literature, we found there was greater retention of knowledge by our ORN compared to skills at 6 weeks. While awaiting follow-up data at 6 months, these early results suggest that skill retention may require more frequent reinforcement than knowledge retention.
1. Williams C et al. Brit J Nurs 2018
2. Yang CW et al. Resuscitation 2012