Neuromuscular Blockade Monitoring: Qualitative Versus Quantitative

Abstract

Anesthesia providers primarily utilize peripheral nerve stimulators (PNS) to monitor train-of-four count to assess neuromuscular function in surgical cases where akinesia is desired by neuromuscular blocking medications. As current studies show, there is a discrepancy between the use of qualitative measurements and quantitative values. When anesthesia providers solely utilize qualitative peripheral nerve stimulator count measurements, such as train-of-four, an over or underestimation of neuromuscular blockade depth can result, contributing to post-operative residual muscle weakness. The goal of this project was to increase the knowledge base of a group of student nurse anesthetists at the Adventist University of Health Sciences on qualitative versus quantitative measures in neuromuscular blockade monitoring, while identifying the superiority of quantitative monitoring. The project was implemented by evaluating student baseline of neuromuscular blockade monitoring knowledge with a pre-test, then presenting a Microsoft PowerPoint on evidence-based research and then administering a post-test. The forms were collected and the data was analyzed utilizing a paired sample t-test for statistical analysis to compare the mean scores and evaluate for an increase in knowledge base in the post-tests as compared to the pre-tests. Based on the results, it can be concluded that the mean test scores increased significantly between the two tests, indicating that the PowerPoint presentation was effective in increasing the knowledge base of the study participants. The increase in mean scores from the pretest to the post-test was 37%. The obtained t value is -10.499 (p < .001).

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