Utilizing Simulation to Promote Medication Preparation and Administration Safety in Anesthesia

Abstract :

Introduction: Anesthetic medication errors occur at a rate of 1 in every 133 doses administered. Student and Certified Registered Nurse Anesthetists (SRNAs, CRNAs) are responsible for the selection, preparation, and administration of high-risk medications, bypassing a verification by a pharmacist or other clinician. Currently, there is no standard modality of teaching SRNAs how to safely and correctly dilute, reconstitute, and prepare various commonly used anesthetic medications. This study utilized low-fidelity simulation to improve SRNA knowledge and confidence surrounding anesthetic medication preparation and administration.

Methods: Using a pretest-posttest design with repeated measures, a sample size of 44 SRNAs participated in a low-fidelity medication preparation simulation. Participants completed a pre-survey assessing knowledge and confidence in medication preparation prior to watching an educational module. Participants completed a simulation including a single dilution, double dilution, and reconstitution of commonly used anesthetic medications. Trained observers scored SRNAs during the simulation using a validated checklist. Participants completed a post-survey immediately and three weeks after the simulation.

Results: Following the educational module and simulation, median scores for knowledge and confidence increased over the course of the study. At the immediate and three-week post survey times, confidence remained significantly increased (p ≤ 0.001). Knowledge was significantly increased immediately after simulation, however waned at the three-week mark.

Conclusions: Low-fidelity simulation for medication preparation and administration can increase SRNA confidence and knowledge regarding anesthetic medication safety. Suggested repetition of the simulation may improve knowledge further. A second simulation is in process and will bring further data prior to presentation.