4 2 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 6
Here are a few tricks for ensuring
your continuous nerve block pro-
gram is humming along at maximum
efficiency and efficacy.
• Start simply. When starting a
CNB program, have your providers
focus on a single block for a single
procedure, says anesthesiologist Adam W.
Amundson, MD, of the Mayo Clinic in
Rochester, Minn. "This will provide expertise,
education and implement a mentorship so
one provider can help another troubleshoot
and gain expertise in that particular block,"
he says.
• Educate patients. Before patients even
arrive for surgery, they should be aware that
they're getting a block and how that will
impact their at-home recovery, says Sharad
K. Khetarpal, MD, MBBS, FFARCSI, a clinical
assistant professor of anesthesiology at the
University of Pittsburgh School of Medicine.
"We inform patients about blocks during a
meeting held the day before their scheduled
procedures," he says. "That way, we don't
have to spend time the morning of surgery
explaining the process. We also include a
family member or escort to explain our pro-
tocols and what to expect after surgery."
• Fine-tune your schedule. Patients
should be brought in at least a half-hour
early to give providers time to place the
blocks, says Jillanea Winchester, BSN, clini-
cal supervisor at the Advanced Family
Surgery Center in Oak Ridge, Tenn. It's also a
good idea to have a designated area for block
placement, complete with all the needed
supplies.
• Employ a block nurse. Having a nurse
who's experienced with CNBs — and not just
a pre-op nurse pulled in to help from time to
time — boosts efficiency and patient safety.
"We need to have an assigned nurse that is
taking care of the patient while we're doing
the block," says Dr. Khetarpal. "We're some-
times so engrossed in placing the block,
which can take 10 to 15 minutes, that things
like vital signs monitoring could be missed."
— Kendal Gapinski
EXPERT ADVICE
Top Tips for
Better CNBs
• DEDICATED HELP Experienced block nurses organize supplies, help keep the schedule
on track and monitor patients when the anesthesia provider is engrossed in
block placement.
Pamela
Bevelhymer,
RN,
BSN
