Graduation Year

2022

Degree Type

Open Access Capstone

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Molly Bradshaw O'Neal

Department Affiliation

Nursing

Second Advisor

Fontaine Sands

Department Affiliation

Nursing

Abstract

Problem: Four million people worldwide die within thirty days of surgery. The EPIC Corporation has created the opportunity to collect and analyze data on the peri-operative care of patients. Initially, implementation of the program has identified barriers to event reporting by anesthesia providers. Barriers identified in the literature and in semi-structured interviews are fear of liability and retribution by patients, employers, and governing bodies. Significance: Despite national efforts to increase the reporting of medical errors, they remain grossly under- reported. The integration of the National Anesthesia Clinical Outcomes Registry (NACOR) events data collection tool into the EHR for anesthesia providers at a large academic medical center showed significant under-reporting following implementation. Accurate completion of the data collection module is imperative to systems development and new patient safety initiatives. Intervention: Staff will receive framed, purposeful messaging in monthly newsletters, a one-on-one Academic Detailing session with handouts, and a REDCap survey. Outcome Measures: The project measures the number of NACOR events reported in the two weeks after conducting Academic Detailing (AD). The number of variables reported will be compared to the same month the prior year. The project also uses the 9-item Provider Satisfaction with Academic Detailing (PSAD) instrument and demographic data collected by REDCap Survey. Results: Statistically significant changes were found in the total number of events reported, the number of CRNAs reporting events, and the different number of variables reported. The PSAD showed a positive response to the AD intervention. The lowest scores were noted in receptiveness to another visit and feasibility to implement. Conclusion: The use of AD to increase reporting of peri-operative complications is a promising alternative to traditional education modules. Staff responded favorably to the intervention and changed behaviors in reporting of events. The collection and evaluation of this data is vitally important to patient safety and quality improvement projects in the department and institution.

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