50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

Improving Regional Nerve Block Safety: A QI Study Using A New Safety Pause Tool

Background

Regional nerve blocks (RNB) are effective and widely used, but as invasive procedures, they pose preventable risks such as wrong-sided block (WSB) and anesthetic toxicity.
The Joint Commission and ASRA recommend the universal protocol, which includes pre-procedural verification, site marking, and time-outs [2-3].
Such safety protocols are increasingly adopted in regional anesthesia to minimize errors and improve patient safety.

Aims

Primary: Mitigate risks associated with RNBs & enhance patient safety by developing a safety tool.
Secondary: Evaluate changes in provider attitudes and perceptions of patient safety following implementation.

Methods

Single-center pre-post quality improvement study using survey data involving the department of anesthesiology and perioperative medicine.
Applied Plan-Do-Study-Act methodology to enhance patient safety (figure 1).
Anesthesia staff received video-based training on anesthetic toxicity and Safety Pause implementation (figure 2).
Pre- and post-implementation surveys evaluated changes in safety perception.

Discussion

The Safety Pause tool was developed to enhance patient safety in RNBs.
Provider confidence in safety measures, error prevention, and workflow efficiency significantly improved post-implementation.
87.9% of respondents found the tool easy to integrate, and significant gains were seen in confidence related to procedural markings, error detection, and anesthetic toxicity management.
The Safety Pause helped avert a wrong-sided block and has caught several instances of missing IVs and bag valve masks.
The tool strengthens adherence to safety protocols, enhances provider preparedness for complications, and fosters a stronger culture of safety in regional anesthesia. Its structured approach could be adapted for wider use in perioperative and procedural settings.

IMPROVING REGIONAL NERVE BLOCK SAFETY: A QUALITY IMPROVEMENT STUDY USING A NEW SAFETY PAUSE TOOL