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Presentation Notes

Quality Improvement podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background: Surgical patients undergoing general anesthesia are 83% more likely to sustain a corneal abrasion perioperatively. A study conducted by the American Society of Anesthesiologists reported that 35% of all ocular injuries were corneal abrasions. Additionally, corneal abrasions account for 3% to 8% of malpractice claims against anesthesiologists and result in a median settlement of $330,000. Pain, increased in length of stay, additional treatment and follow-up visits can contribute to decreased patient satisfaction.

Local Problem: Over an eight-week period in early 2024, 239 patients underwent general anesthesia. Of these patients, 2.1% sustained a corneal abrasion perioperatively. Upon investigation of identified injury rate, no standardized workflow or processes were in place to prevent corneal abrasion injuries.

Method: A multidisciplinary team used Plan-Do-Study-Act quality improvement method to implement and help prevent perioperative corneal abrasions. Anesthesia providers and nurses partnered to provide team-based education on identified trends and corneal abrasion injury rates. After education, the team developed a perioperative corneal abrasion protocol for patients undergoing general anesthesia that included safety measures such as taping eyes immediately upon loss of consciousness and prior to induction activity, installation of ophthalmic drops for specific patients, altering placement of pulse oximetry probe, and patient education focused on not rubbing their eyes when they wake up.

Results/Conclusions: Data collection is in progress and will complete after a total of 24 weeks to ensure sustained process implementation and results. Currently, at eight weeks post-implementation, the corneal abrasion injury rate is 0%.

Implications for Practice: A collaborative, care-delivery approach between anesthesia providers and nurses is crucial to ensure that the risk of corneal abrasions are minimized, and injuries prevented. Following a standardized protocol ensures sustainability of the workflow and prevents corneal abrasion injuries and reduces healthcare costs associated with litigation.

Document Type

Oral/Podium Presentation

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Don’t Scratch Your Eyes: A Quality Improvement Project to Reduce Incidence of Corneal Abrasions

Background: Surgical patients undergoing general anesthesia are 83% more likely to sustain a corneal abrasion perioperatively. A study conducted by the American Society of Anesthesiologists reported that 35% of all ocular injuries were corneal abrasions. Additionally, corneal abrasions account for 3% to 8% of malpractice claims against anesthesiologists and result in a median settlement of $330,000. Pain, increased in length of stay, additional treatment and follow-up visits can contribute to decreased patient satisfaction.

Local Problem: Over an eight-week period in early 2024, 239 patients underwent general anesthesia. Of these patients, 2.1% sustained a corneal abrasion perioperatively. Upon investigation of identified injury rate, no standardized workflow or processes were in place to prevent corneal abrasion injuries.

Method: A multidisciplinary team used Plan-Do-Study-Act quality improvement method to implement and help prevent perioperative corneal abrasions. Anesthesia providers and nurses partnered to provide team-based education on identified trends and corneal abrasion injury rates. After education, the team developed a perioperative corneal abrasion protocol for patients undergoing general anesthesia that included safety measures such as taping eyes immediately upon loss of consciousness and prior to induction activity, installation of ophthalmic drops for specific patients, altering placement of pulse oximetry probe, and patient education focused on not rubbing their eyes when they wake up.

Results/Conclusions: Data collection is in progress and will complete after a total of 24 weeks to ensure sustained process implementation and results. Currently, at eight weeks post-implementation, the corneal abrasion injury rate is 0%.

Implications for Practice: A collaborative, care-delivery approach between anesthesia providers and nurses is crucial to ensure that the risk of corneal abrasions are minimized, and injuries prevented. Following a standardized protocol ensures sustainability of the workflow and prevents corneal abrasion injuries and reduces healthcare costs associated with litigation.

 

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