The Work-As-Imagined vs. Work-As-Done: Evaluation of Locally Adapted Regional Anaesthetic Alert Bracelets

Neurological complications following regional anaesthesia are rare but potentially devastating. Guidelines advise robust systems be in place to monitor recovery after neuraxial blockade and to escalate concerns1.

 

Regional anaesthetic alert bracelets (RAAB) are a simple intervention designed to facilitate the early identification of neurological complications following neuraxial blockade2. They act as a reminder to staff to check for neurological resolution, by checking straight leg raise (SLR), 4 hours after the last dose of spinal or epidural medication. RAAB also support women to self advocate if they have concerns regarding their recovery.

 

At our tertiary obstetric unit, we introduced a modified RAAB, with a QR code to enable access to a relevant multilingual information leaflet (Fig 1.). After a comprehensive education drive of theatre and midwifery staff the RAAB were introduced. A year later, we conducted an audit to identify gaps between the intended (work-as-imagined) and actual (work-as-done) use of the bracelets.