189 - Improving Intraoperative Handoff to Provide Weight-based Local Anesthetics
Description: Surgery requires clear coordination and communication of all disciplines involved in the patient’s care. Standardized communication and handoffs have been shown to improve patient outcomes. Surgical patients on enhanced recovery protocols continues to increase which intraoperatively means an increase use of local anesthetics. The communication of patient weight and their maximum dose for these local anesthetics varies which increases the risk of harm. The team which consist of a perioperative nurse manager, associate director, urology physician assistant and clinical informatics manager collaborated to come up with interventions. The team revised and employed a hand-off sheet that includes patient’s weight and the maximum dose of bupivacaine that can be given. The count board was also revised to reflect the patient’s weight. A maximum dose by weight sheet was placed in each operating room for easy reference. Lastly, the surgical safety checklist (universal protocol) was updated to include discussion of patient’s weight and if local anesthetics is to be given and the corresponding max dose. A survey was then sent out to clinical nurses, surgical technologist, anesthesia team to collect data if the interventions that was formulated are effective and to get additional suggestion and comments from the perioperative personnel. Outcome: The group saw a heightened awareness of weight-based medications. The hand-off tool with the enhanced information is now an essential part in the safe practice of local anesthetic administration. In the future, implementation of new order set is in the process to calculate the weight-based dose admix of local anesthetics.