A university-affiliated tertiary medical center with a newly developed Advanced Heart Failure and Mechanical Circulatory Support program identified the need to implement a more systematic approach to the preanesthesia assessment process for patients with a Left Ventricular Assist Device (LVAD) undergoing noncardiac procedures and standardized guidelines to determine the best blood pressure monitoring system for patients with an LVAD during these noncardiac procedures. A multidisciplinary panel of clinical experts developed an LVAD Preanesthesia Toolkit using standard recommendations identified via evidence-based literature and expert opinion. The Toolkit included an LVAD Preanesthesia Assessment (VaPA) tool and an LVAD Blood Pressure Monitoring Decision Tree. The Toolkit initiative utilized a checklist to promote safety and enhance access to LVAD-specific resource tools for anesthesia providers. An online education module outlining the details of the initiative was distributed to targeted users prior to a pilot implementation of the VaPA tool into clinical practice. Data collection concerning education dissemination revealed that 27.2% of anesthesia providers had reviewed and verbalized their understanding of the initiative. An analysis of the effectiveness of the VaPA tool was conducted in a 5-month retrospective review of electronic health records for LVAD patients undergoing noncardiac procedures. Outcome data revealed 100% accuracy in preanesthesia assessment documentation. Results indicated improved consistencies in documenting the LVAD specific components of the preanesthesia assessment.
Rooney, T., Weimer, C., Giardino, E., Shanklin, K., Pelletier, P., & Rosenblatt, A. (2022). The Development and Implementation of Evidence-Based Preanesthesia Assessment Tools for LVAD Patients Undergoing Non-Cardiac Procedures. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 5 (1). Retrieved from https://digitalcommons.library.tmc.edu/uthoustonjqualsafe/vol5/iss1/1