Archive January 2019 XX, No. 1

The Case for a Block Nurse Coordinator

Our regional anesthesia program ran like a well-oiled machine when we put a point person in charge.

Amy Berardinelli

Amy Berardinelli, DNP, RN, CPAN, NE-BC

BIO

SHEARED SKIN
Cleveland Clinic Hillcrest Hospital
MISSING LINK With the addition of Ted Link, RN, our full-time regional block nurse coordinator (second from left), the efficiency of our block program has dramatically improved.

When it comes to administering regional anesthesia blocks, we're big believers in the invaluable role a dedicated block nurse coordinator can play. It wasn't always that way, though.

Here at the Cleveland Clinic Hillcrest Hospital, we were faced with what was essentially a good problem to have: a growing anesthesia team that was more than willing and certainly able to provide regional blocks so we could reduce the number of opioids we were giving our patients. What wasn't good, however, was how unprepared we were for such growth. We went from doing just a few blocks in a day to up to 20. That's when things got chaotic.

We were trying to do too many things at once: prep patients for surgery, perform nerve blocks and epidurals, and bring patients from the floor for pain blocks. Did I mention that we also run an ambulatory eye center in the same area where all of this intermingling of activity was happening?

There was only one solution to restore order: standardize our block procedures and develop clear protocols on preparing and performing blocks.

Our block process used to be as follows: On the day of surgery, an anesthesiologist would determine whether we were going to do a block. More often than not, that would delay getting the patient into surgery on time and cause anxiety for the patient because no one had discussed the block with him.

Plus, it wreaked havoc on our staffing. Nurses would get pulled out their 3-person assignment to give the block, and the team leader would then have to oversee that nurse's patients and staff would often wind up getting more patients.

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