Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Implementation of contextualized, emergency management cognitive aids in a periodontics clinic

  • Siemens, Mikaela J. (Duke University Nurse Anesthesia Program) ;
  • Rice, Andi N. (Periodontics of Greenville) ;
  • Jensen, Trenton F. (Periodontics of Greenville) ;
  • Simmons (Muckler), Virginia C. (Duke University Nurse Anesthesia Program)
  • Received : 2021.03.01
  • Accepted : 2021.05.10
  • Published : 2021.06.01
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Abstract

Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

Keywords

Acknowledgement

The project team would like to acknowledge the contributions, time, and talents of Duke University School of Nursing statistician, Julie Thompson Ph.D., and the participation and interest from all clinical staff of Periodontics of Greenville, without which the project would not have been possible.

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