measures: a dedicated staff; sterile fields set up to minimize chance of
infection; ultrasound guidance utilized for site location in administer-
ing the local anesthetic; and the monitoring of a sedated patient by
nurses with competency in providing sedation. Ultimately, the bene-
fits of a nerve block outweigh the risks associated with placing it
when the accepted standards of safety for the procedure are followed.
5. Patient-friendly post-op follow-ups
Reinforcing and expanding on patient education is just as important
after the surgery. We follow up with patients the next day to see how
they're feeling, answer any questions and review pain management
strategies. We also ask if there's any information they want that wasn't
covered previously or if their pain is more than they can handle. That
last question is important because it can lead to improvements in our
patient education efforts. If what we're doing is working, we don't
change it; if it isn't, we can brainstorm a plan to get patients to a toler-
able pain level. Usually they are doing well and are thankful for the
follow-up phone call.
Keep striving
Never get complacent with the current success of your block pro-
gram. Continually monitor, evaluate and improve your pain manage-
ment protocols, incorporating advanced information and practices as
medical research and devices evolve and become available. Your
block team should always focus on best practices in safety and effi-
ciency that lead to excellent patient outcomes.
OSM
J U L Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 5
Ms. Kemp (ckemp9@jhmi.edu) and Ms. Wade (cwade6@jhmi.edu) are
perioperative nurses at Sibley Memorial Hospital in Washington, D.C.
