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"Plus, some people pick it up really smoothly and easily, and other people
struggle with it. It takes a lot of commitment and a lot of practice. Even if
you have a natural tendency to be good at it, it takes a lot of practice."
For many, it's also uncharted territory and characteristic of a generation gap. "Most residency programs now teach ultrasound-guided
regional anesthesia," says Dr. Hickman. "But anybody who's been out
of residency for more than 5 years probably didn't get that training."
The expense is another concern that may frighten some administrators, says Barbara Holder, RN, BSN, LHRM, the center's QA coordinator. But it's an investment that pays off, she argues.
"It does take a commitment of having a team to do it," she says. "It's
not just an anesthesia provider showing up and saying, Hey, I'm
going to do blocks for you and it's going to be wonderful. It's really a
concerted effort, because it starts out in admitting, and you have to
run your whole OR schedule based around whether the block is in or
not. From the hospital side, that's all tied to dollars. But if people take
the time to tie it back to an ROI, it's always going to be on the positive
side, because it improves patient satisfaction, and that drives more
patients."
"Our patients wake up comfortable and quicker," says Dr. Hickman.
"Our nausea is less than 3% and our post-discharge nausea is less than
1%. I've seen recent articles that show that the average post-discharge
nausea and vomiting rate to be more like 37%."
Of course, nausea isn't the only concern after patients go home.
Opioids can cause respiratory depression, and for some at-risk individuals, a quick descent into addiction.
Post-op challenges
"Chronic opioid abuse has much more to do with what people are given
to take home, not with what they're given in the facility," says Dr.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | N O V E M B E R 2013
