Educational Intervention for Gastric Ultrasonography Competency among Anesthesia Providers

Abstract

The purpose of this Doctor of Nursing Practice (DNP) project was to assess knowledge in gastric image recognition after an educational presentation. Pulmonary aspiration of gastric contents is a feared anesthetic complication among Certified Registered Nurse Anesthetists (CRNAs) and Anesthesiologists as it is associated with increased patient morbidity, mortality, and healthcare costs, occurring as often as 1 in every 2-3,000 cases (Nason, 2015). Current aspiration risk stratification often solely relies on the American Society of Anesthesiologists (ASA) guidelines or a patient’s “nothing by mouth” (NPO) status. However, these guidelines fail to inform providers about the quality and nature of a patient’s gastric content, which are directly associated with the potential severity of aspiration (Putte & Perlas, 2014). Gastric ultrasonography offers an alternative, valid and reliable assessment of gastric contents and volume allowing anesthesia providers to better predict a patient’s risk of aspiration (Bisinotto et al., 2017). To assess knowledge of gastric image recognition, a pretest of gastric images was administered before an educational presentation with a posttest administered immediately afterward for participants at a hospital in Phoenix. Data analysis resulted in a mean pre-test score of 4.76/8 or 59.6% (SD = 19.4%) and a mean post-test score of 7.06/8 or 88.2% (SD = 10.9%), indicating increased provider accuracy in identifying different types and volumes of gastric contents. In conclusion, anesthesia providers may continue to develop their gastric ultrasonography interpretation skills with hopes of adopting this noninvasive tool into their anesthetic plan of care, ultimately decreasing perioperative aspiration risk thereby potentially improving patient, provider, and healthcare facility outcomes.