Ultrasound-Guided Regional Anesthesia Curriculum: Truncal Blocks

Adam Bizub, RN, DNP, CRNA

DNP Nurse Anesthesia 

Ultrasound-Guided Regional Anesthesia Curriculum: Truncal Blocks

Project Category: Evidence Implementation

Project Team: Adam Bizub, DNP, CRNA Tyler Dougan, DNP, CRNA Kristine Tierney, DNP, CRNA (Advisor)

Abstract

Background: Truncal blocks, regional anesthetics that provide analgesia to the chest, thorax, or abdomen, have been shown to improve patient outcomes, lower costs, and decrease length of stay for patients undergoing thoracic and abdominal surgery. Anesthesia providers are often reluctant to utilize these techniques due to a lack of confidence related to ultrasound-guided regional anesthesia techniques and identification of anatomical structures on ultrasound. Therefore, this project sought to determine the impact of an ultrasound-guided regional anesthesia curriculum on student registered nurse anesthetists’ preparedness and confidence levels when administering truncal blocks.

Methods: Current literature was reviewed to determine the effectiveness of various teaching methods including hands-on practice with expert feedback, instructional videos, and fluency checklists. An instructional video and fluency checklist were developed, and students practiced while receiving feedback from experienced staff. Pre- and post-curriculum preparedness and confidence scores related to performance of truncal blocks were evaluated.

Results: Team 25 students preferred live ultrasound scanning over other methods. Textbook content and assigned readings were the least favored elements of content delivery. Survey results indicated improvements in all areas related to block preparation, setup, and delivery; improvement according to each content area was shown to be statistically significant. The largest increase in student preparedness and confidence levels were related to the identification of nerves and relevant structures with a mean increase of 48.98% (79.08 vs 53.08, p<0.001).

Conclusion: Confidence levels were increased after delivery of the truncal block curriculum.

Full Manuscript Slide Presentation Video