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Intraoperative Eye Protection for Prevention of Corneal Abrasion

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2024-05
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DNP Project
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Problem: Corneal abrasion (CA) is a common complication in patients undergoing general anesthesia (GA) for surgeries unrelated to the eyes. Patients undergoing GA can develop CA due to the loss of some physiologic eye-protective reflexes while under GA. The anesthesia department in a midsize community hospital noticed a 2% increase in the incidence of CA in perioperative patients who received GA for non-ocular surgeries. Evidence review confirms utilization of a CA prevention protocol as well as continuing education for anesthesia providers on CA prevention resulted in a decrease in CA in patients receiving GA. Purpose: This quality improvement (QI) initiative aims to educate anesthesia providers on CA prevention and promote provider adherence to an evidence-based intraoperative CA prevention guideline. Method: This QI project took place over 15 weeks, from September to December 2023. The intraoperative CA guideline was created by the project lead (PL) and approved by the site. The PL conducted an in-person education via PowerPoint presentation for all 25 full-time anesthesia providers during a staff meeting. Attendance was measured by the PL using the staff education survey completed by the providers. Compliance with the use of the guideline was measured using the CA guideline survey completed daily by anesthesia providers for all patients receiving GA. Results: The staff education survey was completed by 8% of anesthesia providers. 100% compliance was noted during the first week of implementation and the lowest compliance rate of 0% was noted on weeks 5 and 15, respectively. The median compliance rate for the guideline use dropped from 33 to 25 from weeks 11 through 15. Conclusions: A QI project implementing an intraoperative CA prevention guideline has great potential and feasibility for improving the quality of care delivered to patients and enhancing patient outcomes during the perioperative period.

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