Problem: Nurse anesthetists experience little difficulty with oral and nasal intubations on the majority of surgical patients. However, there are patients that present with unanticipated difficult airways, and anesthesia providers are required to have the knowledge and the skill to use various techniques to secure the airway. The fiberoptic bronchoscope (FOB) is an essential airway tool that requires a level of knowledge and skills to operate; yet, many nurse anesthetists, find fiberoptic-guided intubation difficult to perform. Anesthesia providers and patients are stakeholders at risk in underutilization of life saving techniques such as FOB. Therefore, it is necessary for nurse anesthetists to develop a level of knowledge and skill to be confident in the use of the FOB for intubation of the trachea. Purpose and Scope: The purpose of this capstone project was to assess the level of knowledge and skill of nurse anesthetists with the FOB for intubation before and after a selected teaching intervention. The rationale for the project was for nurse anesthetists to know and become familiar with the proper steps in FOB for intubation and to use the instrument clinically. In addition, a protocol or set of guidelines for the anesthesia departments of a primary care facility is proposed along with an annual review of the FOB for intubation. A yearly review will ensure project sustainability. FOB is a component of the curriculum in the school of nurse anesthesia and as a part of the curriculum the project is sustainable and useful for future anesthetists. Goal: The goal of the project was to successfully implement a select teaching intervention with the FOB for intubation by nurse anesthetists to enhance patient care within a primary healthcare organization and its affiliated clinical site nurse anesthetists. Objectives: First was to describe demographic characteristics of nurse anesthetists. Second was to describe pre-intervention knowledge and skill of nurse anesthetists related to FOB for intubation. Third was to desribe post-intervention knowledge and skill of nurse anesthetists related to FOB for intubation. Fourth was to statistically measure knowledge and skill before and after a selected teaching intervention with FOB for intubation. Plan: Phase One: A needs assessment was conducted using published evidence. Phase Two: A select teaching intervention for nurse anesthetists was designed using an Evidence Based approach. Phase Three: An evidence-based teaching intervention was implemented for a projected sample. Phase Four: The level of knowledge and skill before and after a selected teaching intervention was evaluated, using the Global Rating Index for Technical Skill (GRITS). Outcomes and Results: Using a descriptive research design, results of the pre-intervention and post-intervention meaures revealed the level of knowledge and skill with FOB for intubation. The scale of reliability on internal consistency for pre-intervention testing achieved significance of. Post-intervention testing achieved significance with regard to the instrument’s performance. In this interventional design study, the GRITS tool was the ideal assessment for the level of knowledge and skill for the nurse anesthetist.
