Development of a Clinical Practice Guideline for Monitoring Neuromuscular Blockade

Abstract

After neuromuscular blockade is achieved in the surgical setting, it is important that the patient obtain adequate recovery. If the patient is extubated and sent to the post-anesthesia care unit without adequate recovery, there is a higher incidence of respiratory complications. Newer technology has made objective neuromuscular junction monitoring more available and affordable than in the past. The purpose of this Doctor of Nursing Practice (DNP) project was to develop a clinical practice guideline (CPG) to assist practitioners in monitoring residual paralysis. As a theoretical framework, Lewin’s Change Theory and the Knowledge to Action Framework was used to move current research into practice. Expert opinion was acquired to assist in the development of a CPG. The CPG was then appraised by four anesthesia providers to ensure that a high-quality CPG, ready for implementation, was developed. The CPG was appraised using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) assessment platform. The results were clear that the CPG exceeded the 70% required to ensure a high-quality CPG with the scores for each domain ranging from 92% to 98%. All appraisers stated they would recommend the CPG for implementation into practice.