Emily Hartman, DNP'20, published her QI capstone project, "Sugammadex Effects on Hormonal Contraception Effectiveness: Implementation of Uniform Postoperative Teaching," in Journal of PeriAnesthesia Nursing. Additional authors include Emily Funk, assistant professor, and Kathy Pereira, professor emerita, who were also committee members, and Guy Dear and Carol Wellman with Duke Hospital. 

Abstract

Purpose

The purpose of this quality improvement project was to improve consistency of discharge teaching in women who used progesterone-containing hormonal contraceptive medications and received sugammadex during general anesthesia, as there is a risk of unintended pregnancy for 1 week after administration of sugammadex.

Design

This project used a predesign and postdesign using two separate sample groups of patients and postanesthesia care unit (PACU) nurses.

Methods

The sample consisted of 31 total women of childbearing age and 59 PACU nurses. Simplification of sugammadex discharge instructions was achieved by incorporating evidence-based recommendations for electronic discharge instructions and nursing education. PACU nurses were educated and surveyed before and after regarding frequency of discharge teaching, clarity, and comprehension of the after-visit summary and knowledge of sugammadex. Patients were called via telephone postoperatively to assess recall of sugammadex discharge teaching.

Findings

Postoperative patient phone calls identified a small increase in patient recall of discharge instructions from 5 of 14 patients (35.7%) before implementation to 7 of 17 after implementation (41.2%). PACU nurse surveys indicated an increase in self-reported frequency of sugammadex discharge teaching (34.8% vs 64.2%, P = .024) and that new discharge instructions contained more clear, comprehensive information as compared with previous instructions (29.4% vs 75.5%, P = .001).

Conclusions

This quality improvement project successfully implemented more consistent and comprehensive discharge instructions for women who receive sugammadex intraoperatively. Limitations of the project included a small sample size and short implementation intervals. As a result of switching to uniform discharge instructions, more patients received important discharge teaching from PACU nurses, and the percentage of patients who recalled this information increased.

Citation

Emily Hartman, Emily Funk, Guy Dear, Carol Wellman, Katherine Pereira, Sugammadex Effects on Hormonal Contraception Effectiveness: Implementation of Uniform Postoperative Teaching, Journal of PeriAnesthesia Nursing, 2021, ISSN 1089-9472, https://doi.org/10.1016/j.jopan.2020.10.007. (https://www.sciencedirect.com/science/article/pii/S1089947220303646)