• Implementation of Music to Reduce Preoperative Anxiety in Gynecologic Patients

      Okoyechira, Nkiruka N.; Gutchell, Veronica (2022-05)
      Problem & Purpose: Anxiety is defined as a feeling of nervousness, fear, and high autonomic activity. An estimated 60% to 92% of patients undergoing surgery experience significant preoperative anxiety related to fear of death, mistakes from providers, and disability. Evidence suggests that preoperative anxiety is associated with patient dissatisfaction and negative outcomes such as higher levels of opioid requirement. The anesthesia providers anecdotally estimated preoperative anxiety among adult patients undergoing hysteroscopic gynecologic (GYN) procedures at the practice site at 70%. The purpose of this Quality Improvement (QI) project was to implement music in the preoperative unit to reduce anxiety in adult patients undergoing hysteroscopic GYN procedures. Methods: This QI project was implemented over 14-weeks from September through December 2021 following the Human Research Protection Office (HRPO) and the facility Institution Review Board (IRB) approval. Approximately 45 Medical Doctors of Anesthesiology (MDAs) and Certified Registered Nurse Anesthesiologists (CRNAs) were included in the project and educated on the project goal and implementation process. Patients who met the inclusion criteria were provided music by the anesthesia providers in the preoperative unit using music players and disposable headsets. Data was collected on providers’ compliance using student developed data collection tool. Weekly run chart analysis was used to track progress. Results: There was an overall increase in the number of providers who offered music. Compliance ranged from 0% to 55%. On average, 26% of the providers offered music in the 14-weeks. Conclusion: It was feasible for the anesthesia providers to offer music in the preoperative unit to reduce anxiety.
    • Preoperative Music to Decrease Anxiety in Patients Undergoing Gastrointestinal Procedures

      Soyan, Samiat A.; Gutchell, Veronica (2021-11)
      Problem & Purpose: Anxiety is an emotional state characterized by feelings of nervousness and worry that affect 85% of patients undergoing surgery and general anesthesia. Anxious patients have reported more postoperative pain, which leads to an increase in the use of analgesics, risk of infection, duration of hospitalization, and delayed wound healing. The anesthesia providers at the practice site anecdotally estimated that 80% of patients scheduled for gastrointestinal (GI) procedures are anxious. The purpose of this quality improvement (QI) project was to implement the preoperative use of music to reduce anxiety in adult patients undergoing GI procedures. Methods: This QI project was implemented from September 7th to December 31st of 2021. Approximately 15 registered nurses (RNs) and 43 certified nurse anesthetists (CRNAs) and anesthesiologists were included in this project. The providers were educated on the benefits of preoperative music to reduce anxiety and offered music to patients that met the inclusion criteria (age > 18, patients’ consent, etc.) Provider compliance was collected weekly and reasons for noncompliance were assessed and addressed. Results: In the first seven weeks of data collection, 18.5% of patients admitted to the GI suite were offered music. After including student registered nurse anesthetists in the project, the average percentage of patients offered music increased from 18.5% to 41.5% for the last four weeks of the project. Conclusions: Listening to music is effective for reducing the anxiety of preoperative patients; most especially, in patients scheduled for endoscopies and colonoscopies in which anxiolytics are typically not offered. The project demonstrated that patients are enthusiastic about being offered music and are willing to implement the intervention.This project also highlighted providers’ compliance with offering music to patients in the GI suite to reduce anxiety.