Best Practice for Anesthesia for ECT: Quality Improvement Review and Guideline Development for ADU SRNAs at Florida Hospital

Abstract

Electroconvulsive Therapy (ECT) is a safe and effective treatment for various psychiatric disorders. ECT treatment entailed the delivery of an electrical current via electrodes applied to the scalp that produce a generalized therapeutic seizure. Due to the nature of the procedure and for patient safety and comfort, the anesthetic of choice is general anesthesia. Unlike other general anesthesia cases, the anesthetic goals for ECT are a rapid induction, deep muscle relaxation without interference with seizure quality and length, and a rapid emergence. Due to the fast pace, multiple providers, and a multitude of distractions during ECT procedures, new providers, such as Student Registered Nurse Anesthetists (SRNAs), are at an increased risk for committing a medication error. This lack of knowledge and understanding of the ECT procedure and clinical setting can potentially impact patient care.

Henceforth, the primary purpose of this project was to design a protocol intended to establish a safe process for preparing and labeling high-risk medications commonly used during ECT treatments by SRNAs. The sample population utilized in this project was the Adventist University of Health Sciences’ Nurse Anesthetist Program SRNAs class of 2018. The intervention used to address the problem is through a pre-test, a 30 to 45 minute PowerPoint presentation, and a post-test. The anticipated outcome of the PowerPoint presentation was an increase in the level of knowledge and understanding of the participants as demonstrated by improved post-test scores, indicating an effective PowerPoint presentation. The statistical analysis results of the pre- and post-test indicated significant increase in the level of knowledge of SRNAs after the PowerPoint presentation.

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