Date of this Version

2024

Document Type

DNP Project

Rights

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Abstract

Background: Hypothermia affects 50%-90% of patients undergoing anesthesia. It is a common issues anesthesia providers face in the perioperative period. It can lead to many adverse events such as coagulation problems, cardiac instability, prolonged recovery, and impaired immune function. This can lead to complications such as surgical site infections. There are approximately 500,000 patients who obtain a surgical site infection (SSI) each year. To mitigate the risk associated with hypothermia, anesthesia providers negate the temperature changes during the perioperative period with patient warming interventions. One of the most used equipment is a forced air warmer (FAW). Recent studies show FAWs having the ability to introduce bacteria into its surrounding environment leading to an increase in risk of SSIs. This project aimed to improve anesthesia provider knowledge on the risks of perioperative forced air warming and SSIs.

Method: A literature review on FAWs was conducted and determined the need to spread awareness to providers on the potential increase of surgical site infection when used. An online module was created and presented to anesthesia providers at Mount Sinai Medical Center. There was a pre- survey to assess provider knowledge on FAWs and SSIs. A post- educational module survey to assess knowledge gained from participation. An online platform was utilized to obtain consent, disbursement of surveys and module and anonymous data collection.

Results: Twelve certified registered nurse anesthetists (CRNAs) participated in the survey. Of these, 59% stated they have not been aware of maintenance on FAWs and 67% stated they use FAWs 10+ hours a week. Of the 9 knowledge-based questions, 66.67% (n = 6) had an increase in correct response rate. It should be noted that 1 participant dropped out before the post- survey. The 3 questions regarding provider practice had more participants agreeing they are likely to perform an infection risk assessment preoperatively.

Discussion: Data from the surveys showed positive improvement for practice. The providers showed an increase in knowledge after the educational module, and all 3 of the provider practice-based questions showed that more providers are more likely to implement interventions to help decrease the risk of surgical site infections for their patients. It is interesting to note that the number of providers who have an increased use of FAWs and the number of providers aware of FAWs maintenance have an inverse relationship. This could be for several reasons, but making providers aware of the need for maintenance was part of the overall objective. The study was limited mainly because of its sampling size. Being able to distribute the survey to other facilities could increase the numbers and broaden the data. With the small sample size, having one participant fail to complete the post-survey negatively affects being able to compare the data from the surveys. In conclusion, the educational module improved anesthesia providers' knowledge on FAWs and SSIs. However, there needs to be further research on FAWs and their relationship to SSIs.

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