SUGAMMADEX AND HORMONAL CONTRACEPTIVES: IMPROVING EDUCATION AND DOCUMENTATION

Purpose/Objective The objective of this DNP project was to improve perioperative counseling for female patients of reproductive age about the decrease in efficacy of hormonal contraceptives with Sugammadex administration and make this education readily available in the discharge instructions. Sugammadex is a neuromuscular blocker reversal agent given perioperatively that encapsulates steroidal non-depolarizing neuromuscular blocking agents and renders them inactive. However, other drugs share a similar steroid-based structure and can result in Sugammadex binding to medications that contain estrogens and progestin, which are often found in hormonal contraceptives. Sugammadex can decrease the efficacy of hormonal contraceptives and potentially lead to unintended pregnancy if proper education is not provided to the patient. Methods The Iowa Model helped systematically guide this project, and there were three deliverables. An intraoperative Clinical Decision Support Tool (CDS) tool, a Patient Instruction Note function with a “smart text” option, and an in-service to educate anesthesia staff and Post-Anesthesia Care Unit (PACU) nurses about the first two deliverables. Pre- and post-education questionnaires were used to gather baseline data and data after one month of intervention implementation. A statistical analysis of pre-and post-education data was conducted to determine the effectiveness of the intervention. Results A CDS tool was successfully developed and implemented with a “smart text” option to a pilot facility. The educational module did yield a significant change in anesthesia provider understanding that Sugammadex decreases the efficacy of hormonal contraceptive efficacy from the pre-and post-test responses (p < 0.05). Conclusion: These results demonstrated an increase in knowledge about the interaction between Sugammadex and hormonal contraceptives; however, more research is needed to determine if a significant change in practice occurred