Date of this Version

2023

Document Type

DNP Project

Abstract

Background: Propofol is a favored intravenous anesthetic; however, studies have shown propofol to have an unstable hemodynamic profile. Currently, myocardial infarction, secondary to intraprocedural hypotension and myocardial ischemia, is the leading cause of postoperative death. Despite its potential for severe adverse effects, propofol remains the leading intravenous anesthetic agent for the induction of general anesthesia and monitored anesthesia care (MAC).

Objective: This project sought to compare the effectiveness and hemodynamic profile of remimazolam and propofol for the induction of anesthesia. Therefore, the primary goal of this Doctor of Nursing Practice (DNP) project was to construct and display an educational quality improvement module for anesthesia providers, educating them regarding the novel drug remimazolam as an alternative to propofol for induction of MAC.

Method: A literature review comparing remimazolam and propofol as induction agents was conducted. With the obtained information, an online educational module was created to present to anesthesia providers. A pre- and post-assessment survey was administered to statistically calculate the knowledge acquired from the educational module. The project was developed and disseminated to Florida International University’s Department of Nurse Anesthesiology alumni using an online platform that broadcasted the module, provided anonymity for the surveyors, and provided unbiased data collection.

Results: The project established predetermined benchmarks to assess success and quantify knowledge acquisition through the educational module. Specifically, a 20% increase in the average of correct answers from the pre- to post-assessment or an overall average of 85% in the post-assessment was considered indicative of project success. The analysis revealed that the average percentage of correct responses on the pre-assessment survey was 63.6%, while the post-assessment survey yielded an average of 85.5% correct responses. These findings demonstrate a substantial increase in knowledge of 21.9% following participants' exposure to the educational module.

Discussion: The project demonstrated its efficacy in meeting the established benchmarks by analyzing both the pre- and post-assessment surveys. The discernible enhancement in learning outcomes attests to the favorable influence of the educational intervention, significantly improving participants' comprehension of the subject matter.

Conclusion: The educational module implemented in this project yielded significant improvements in the knowledge and attitudes of anesthesia providers regarding the utilization of remimazolam as an alternative to propofol for the induction of MAC. By disseminating knowledge about remimazolam and its potential benefits, this project contributes to advancing evidence-based practice and enhancing patient care during the induction of monitored anesthesia care.

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