Assessing the Adequacy of a Newly Developed Corneal Abrasion Prevention Guide in High-Risk Cases (Spinal Surgeries) at A Large Academic Medical Center

Abstract

Corneal abrasions can occur during and after general anesthesia. CRNAs are required to ensure protective measures are implemented, remain intact throughout the duration of surgery, and to document protection measures implemented. There are currently no nationally recommended standards of practice for CRNAs to implement to protect their patients from perioperative corneal abrasions. The purpose of this QI project was to assess CRNAs’ preferences and practices regarding eye care and corneal abrasion prevention and whether or not they perceived a newly developed corneal abrasion quick reference guide as a useful tool for their practice to prevent corneal abrasions. In this QI project, a simple educational initiative involving the use of a corneal abrasion quick reference guide and educational PowerPoint improved CRNA reported confidence in their ability to identify patients at high risk, implement appropriate prevention practices, and diagnose and treat corneal abrasions. CRNAs reported that the corneal abrasion quick reference guide was useful for their practice, was a good reminder of high risk cases, and provided guidance on how to best prevent corneal abrasions. This QI project also led to the development of an improved documentation method at the partnering institution. Anesthesia led treatment of corneal abrasions, as opposed to ophthalmology management, has been demonstrated to reduce the time to treatment. The improvement in CRNA perceived confidence in ability to treat corneal abrasions could lead to faster PACU discharge, decreased operating room delays and the cost associated with each.