Promoting Patient Safety During Intranasal Esketamine Administration

Abstract

Purpose: Strengthen La Frontera psychiatric provider and nursing staff knowledge regarding intranasal esketamine therapy, promote safety of intranasal eskatamine administration at La Frontera, and increase intent to use a formal safety protocol during administration and patient monitoring. Background: Treatment-resistant depression affects nearly one-third of individuals diagnosed with major depressive disorder. Intranasal esketamine therapy is a new treatment available for individuals with treatment-resistant depression, and carries a significant risk profile, requiring administration and monitoring at designated clinics authorized to prescribe it. Presently, no standardized safety protocol exists to monitor patients during esketamine therapy sessions. Methods: This was a quality improvement project. The invited participants were 13 psychiatric providers and registered nurses at La Frontera in Phoenix, Arizona. The project design was an asynchronous educational PowerPoint presentation with pre- and post-presentation surveys delivered through Qualtrics via emailed hyperlink. Participation was voluntary and anonymous. Results: One invitee (n=1) participated in the intervention and submitted completed surveys. The sole participant indicated in their survey responses that their knowledge of intranasal esketamine therapy was enhanced. They further indicated a strong intent to use the proposed safety protocol were it to be implemented by La Frontera. 10 Conclusions: While the survey results indicate the participants’ knowledge of intranasal esketamine and intent to use a safety protocol was enhanced by the educational presentation, the small number of participants (n=1) made it very difficult to extrapolate any meaningful data regarding whether or not psychiatric providers and nurses at La Frontera found the educational presentation useful or informative, or whether a general sentiment in favor of adopting the safety protocol exists among La Frontera staff. This project provides an initial foundation for future research regarding the adoption of a standardized safety protocol among outpatient clinics administering intranasal esketamine. Further inquiries could help identify and overcome potential barriers, including alternative implementation strategies as well as modifications to the safety protocol to promote brevity.