A College of Nursing research team led by nurse anesthetist Darryl DuVall, D.N.P., will conduct a study that will help establish national practice standards to improve anesthesia safety during and after surgery. With a two-year, $322,246 grant from pharmaceutical company Merck, the team will examine the use of neuromuscular blockade monitoring in surgeries performed at two Spokane hospitals: Sacred Heart Medical Center and Holy Family Hospital.
Neuromuscular blocking agents are used to relax skeletal muscles to prevent muscle movement during surgery. Their effects are reversed post-surgery by administering reversal drugs, but timing is critical for those to work as intended. Neuromuscular blockade monitoring helps anesthesia providers determine when to administer the reversal drug and when full recovery has been reached, reducing the chances of complications such as respiratory problems. Yet, previous studies suggest that as many as 10 percent of providers never use monitoring, said DuVall, a clinical associate professor and director of the Doctor of Nursing Practice Program.
The team will analyze data from an estimated 27,000 medical records from 2015 to determine monitoring rates in surgeries involving neuromuscular blockade. Based on their findings, they will conduct a practice change intervention and determine its effectiveness at improving monitoring rates, based on another set of data collected over the following six months.
Their study outcomes will be put to immediate good use in another aspect of the project. “We will be collaborating with the American Association of Nurse Anesthetists to develop practice standards for neuromuscular blockade monitoring, which aren’t currently in place,” DuVall said. “It’s great for patients.”