IMPLEMENTATION OF AN INTRAOPERATIVE COGNITIVE AID TO GUIDE SUGAMMADEX USE FOR PHARMACOLOGIC REVERSAL OF NEUROMUSCULAR BLOCKADE

The incidence of residual neuromuscular blockade (rNMB) following general anesthesia remains as high as 60%, placing patients at an increased risk of developing postoperative pulmonary complications (PPCs) (Saager et al., 2019). PPCs are associated with increased readmission rates, hospital length of stay, and overall morbidity and mortality (Kirmeier et al., 2019). A quality improvement project was conducted to examine anesthesia providers' current practice using sugammadex compared to evidenced base practice guidelines revealed throughout a comprehensive literature review. An anonymous survey was distributed among anesthesia providers throughout a level 1 trauma center to identify their current practice and knowledge regarding the use of sugammadex. Seventy-seven anesthesia providers completed the survey. Almost all providers correctly identified that sugammadex interferes with hormonal birth control, while only 58% were found to correctly dose sugammadex according to the patient's actual body weight. Thirty-seven percent of anesthesia providers revealed they avoid administering sugammadex in patients with kidney disease. A cognitive aid was developed and placed throughout the operating rooms, targeting knowledge gaps identified in the survey. This quality improvement project recommends continuing the analysis of current practice trends, as this will help inform and promote best practices consistent with contemporary literature.