Date of this Version

11-28-2023

Document Type

DNP Project

Abstract

Background

Since its debut in the US market, electronic vapor delivery systems (EVDS) have become a significant social trend. Compelling evidence points to a meteoric rise in e-cigarette usage throughout the US, particularly among young people. Presently, 3.6 million teenagers and 10.8 million adults use ECs, with a proliferation of utilization increasing from 0.6% in 2011 to 11.3% in 2017 and from 2.4% to 6% in adolescents and adults, respectively. In patients with a vaping history, does a modified preoperative assessment enhance the anesthetic management? The primary goal of this DNP project was to improve the knowledge of the deleterious effects of ECs use among anesthesia providers and develop a focused assessment for adequate surgical risk stratification and enhanced anesthetic management of patients with a history of vaping.

Methods

The principal methodology of the planned project was to administer an electronic educational module to anesthesia providers that focuses on improving the knowledge of the harmful effects of ECs use and promoting an enhanced assessment and anesthetic management of patients with a history of vaping. The first phase implemented the project by conducting an online pretest to gauge baseline knowledge and attitudes on the subject. The second phase comprised a voiceover PowerPoint presentation as the primary means of learning that included essential information regarding ECs use, related physical alterations in different body systems, and the anesthesia implications and related management for patients with a history of vaping. The project's third phase involved a posttest to evaluate knowledge gained and any changes in anesthesia provider attitudes about the subject presented.

Results

Nine (n=9) participants consented to partake in the educational module, and 100% completed the pretest and posttest questionnaires. Most participants were female (n=7, 77.78%), as opposed to male (n=2, 22.22%). The results assessed the knowledge gained from the educational intervention module. Most questions validated increased correct answers when the pretest and posttest interventions were compared.

Discussion

The results indicated a statistical difference in the pretest and posttest following the educational module. The data exhibited a percentage increase in the providers' knowledge of the main active components of ECs and the ventilatory complications associated with ECs usage. One key outcome is the 44.45% increase in the number of providers extremely likely to implement an enhanced preoperative respiratory assessment for patients with a chronic vaping history. One major limitation is the small sample size (n=9) despite the more significant number of prospective participants (n=44) invited to participate, yielding a response rate of only 20.45%. In conclusion, the QI project aimed to improve the knowledge of anesthesia providers regarding ECs usage and its related physical alteration, in addition to motivating anesthetists to implement a more focused preoperative assessment for this patient population. The author believes the data showed that the QI project increased anesthesia providers' knowledge and attitudes. A positive correlation exists between the knowledge gained and increased affirmative attitudes toward implementing change.

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