Utilization of Quantitative Monitoring to Promptly Detect and Reduce the Occurrence of Residual Paralysis in the Post-Anesthesia Care Unit

Objective: To evaluate the effectiveness of an educational workshop using an Objective Structured Clinical Examination (OSCE) on quantitative neuromuscular monitoring. The goal was to improve the knowledge and skills among certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) in identifying residual paralysis. The specific aim was to determine the effectiveness of quantitative monitoring in the Post Anesthesia Care Unit (PACU). Background: Residual paralysis following the administration of neuromuscular blocking drugs (NMBDs) is a significant postoperative complication. Neuromuscular blocking drugs (NMBD) facilitate airway management and manipulation of surgical fields. Quantitative monitoring can be crucial in early detection and prevention of residual paralysis. Methods: A workshop assessed participants' understanding of neuromuscular blockade, quantitative monitoring, and the ability to differentiate between residual paralysis and other causes of respiratory depression. A literature review was conducted prior to the workshop. Pre- and post-test assessments were administered to measure knowledge acquisition. Results: A significant mean-score increase was observed between pre-and post-tests, indicating improved knowledge and skills in quantitative neuromuscular monitoring. Participants demonstrated an enhanced understanding of key concepts, including the proper placement of electrodes, the significance of TOF ratios, and the appropriate use of reversal agents. Overall, the participants agreed that the workshop was beneficial. Conclusion: The OSCE-based workshop effectively improved participants' knowledge and skills in quantitative neuromuscular monitoring. Implementing such educational initiatives can contribute to safer patient care by reducing the incidence of residual paralysis and associated complications.