Background:  
AAGBI  guidelines[1] advocate  the  use  of  capnography  for  all  patients  who  are  deeply  sedated  or  have  a  supraglottic  airway  or  endotracheal  tube  in  situ.  The  4th  National  Audit  Project  highlighted  the  role  of  capnography  in  earlier  identification  of  obstructed  airways  in  recovery,  noting  the  limitations  associated  with  poor  interpretation[2].  Having  identified  limited  use  of  capnography  in  recovery  and  poor  nurse  confidence  in  interpretation,  we  planned  an  education  program  to  address  this.  

Materials  and  Methods:  
An  education  package  for  recovery  staff  was  developed  from  an  already  established  program[3].  A  survey  of  confidence  in  capnography  use  and  an  assessment  of  knowledge  was  undertaken  by  the  staff  before  and  after  the  education  sessions.  The  education  was  delivered  as  small  group  tutorials  covering  practical  aspects  of  capnography  use.  Test  scores,  maximum  21,  were  compared  using  a  paired  student’s  t-test.  Confidence  was  reported  on  a  scale  of  1  (no  confidence)  to  5  (very  confident).    

Results:  
Twenty  recovery  staff  members  (83%)  attended  tutorials  in  5  groups.  The  mean  test  score  rose  from  7.85  (SD=3.34)  to  17.45  (SD=2.68)  following  the  education  session  (p<0.05). 
The  percentage  of  nurses  who  rated  their  confidence  as  3  or  more  rose  from  13%  to  100%  following  the  education  package.  

Conclusion: 
The  results  show  the  education  package  has  increased  recovery  staff  knowledge  and  confidence.  This  improvement  has  already  led  to  greater  adoption  of  capnography  use  in  recovery.  Ultimately  this  should  improve  patient  safety  by  aligning  our  unit  with  national  standards.  

References:
[1]  Association  of  Anaesthetists  of  Great  Britain  and  Ireland.  Recommendations  for  standards  of  monitoring  during  anaesthesia  and  recovery  2015.  Anaesthesia  2016;  71:  85-93
[2]  TM  Cook,  N  Woodall,  C  Frerk.  Major  Complications  of  airway  management  in  the  UK:  Results  of  the  Fourth  National  Audit  Project  of  the  Royal  College  of  Anaesthetists  and  the  Difficult  Airway  Society.  Part  1:  Anaesthesia.  British  Journal  of  Anaesthesia  2011;  106(5):  617-631
[3] Capnography  resources.  Scottish  Paediatric  Anaesthetic  Network.http://www.span.scot.nhs.uk/?page_id=873 [Accessed  15  December  2017] 

02 / Using capnography: Delivery of an education package for recovery nursing staff.