Date of this Version

11-18-2024

Document Type

DNP Project

Abstract

Abstract

Background: Orthopedic operations of the shoulder joint have been the second most performed surgery in the orthopedic specialty.The advantage for better visualization of intraarticular structures has made the beach chair position the preferred choice for most orthopedic surgeons. However, this position incurred potential complications for the patient if close hemodynamic monitoring was not performed. Significant fluctuations in blood pressure could go undetected during intervals of intermittent blood pressure monitoring which may lead to peri-operative complications.Continuous, non-invasive blood pressure monitoring has offered a beat-to-beat blood pressure reading that could alert the anesthetist of the exact moment when changes in blood pressure occur and how to treat this occurrence diligently. For patients undergoing surgery in the beach chair position, continuous, non-invasive hemodynamic monitoring could provide a more efficient and rapid response to intra-operative hypotension when compared to intermittent blood pressure devices.

Methods: The databases utilized for conducting research included PubMed, CINAHL, and Cochrane Library. Articles were selected based on year of publication, relevance to the researched topic, and evidence supporting the benefits of using continuous, non-invasive hemodynamic monitoring. Surveyors were provided with a pre-test and post-test questionnaire to complete before and after participating in an educational module.

Results: The results yielded ten, high-level research articles that were used to perform a literature review secondary to their relevance and current evidence. The articles used in the review supported the use of continuous, non-invasive hemodynamic monitoring for optimizing peri-operative patient outcomes and minimizing the complications associated with untimely detection of intra-operative hypotension. The results of the pre-test and post-test questionnaire indicated an improvement in knowledge regarding the use of continuous, noninvasive hemodynamic monitoring.

Discussion: The current literature supports the use of continuous non-invasive hemodynamic monitoring for its accuracy in blood pressure readings, ease of use, and ability to detect hypotensive episodes as they occur. This technology has proved to enhance peri-operative outcomes in patients undergoing surgical procedures by allowing clinicians to detect hypotensive episodes in real time and provide timely treatment to decrease morbidity and mortality. The results of the pre-test and post-test questionnaire demonstrated an increase in knowledge regarding use of continuous, noninvasive hemodynamic monitoring and a likelihood for using this technology in practice for patients undergoing surgery in the beach chair position. Limitations included a small sample size of surveyors and insufficient time for significant data collection. In conclusion, the continuous, non-invasive hemodynamic monitor proves to benefit anesthesia practice by improving patient outcomes post-operatively.

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