Education And Evaluation on Carbohydrate Loading Before Cardiac Surgery: A Quality Improvement Initiative

Abstract

Purpose. This quality improvement initiative aimed to introduce the essential concepts of oral carbohydrate loading (OCH) and assess cardiovascular surgical nurses’ knowledge and perceived confidence in incorporating OCH into their practice following an educational presentation.Background. Cardiovascular disease is the leading cause of death and disability and a significant source of healthcare spending in the United States. Advanced cardiovascular disease may require surgical intervention, and most morbidity and mortality occur during the postoperative period. A method to improve postoperative outcomes is blunting the effects of the surgical stress response and ensuing complications by limiting pre-operative fasting and providing a clear-liquid carbohydrate beverage two hours before anesthesia induction. Despite the current evidence-based recommendations on OCH and limiting pre-operative fasting, St. Joseph Hospital does not educate the nurses nor practice OCH. Methods. Cardiovascular nurses were invited to participate in a voluntary, online, and on-demand educational presentation on the core essentials of OCH. Participants took a pre-survey to assess their baseline knowledge, perceived confidence in understanding the content, and likelihood of integrating OCH into their practice. Following the presentation, the participants took a posttest to assess the effectiveness of the education on their knowledge and confidence in changing their practice. Results. The averages between the pre-posttest scores were compared using inferential statistics. Knowledge of OCH improved from an average score of 3.6 to 4.3, t (8) =0.04, p <0.05. Confidence in understanding the content improved from 1.8 to 3.9, t (8) =.003, p <.05. Lastly, the likelihood of integrating OCH into practice increased from 3.7 to 4.4, t (8) = .04, p<.05. Conclusions. The educational session on OCH's benefits, indications, and contraindications resulted in a statistically significant improvement in knowledge, confidence in knowing the content, and likelihood of integrating OCH into practice.