Using a Cognitive Aid to Improve Confidence in Counseling Regarding Current Anesthesia-Related Breastfeeding Recommendations.

PURPOSE: Although most anesthetic drugs are classified as compatible with breastfeeding, literature shows that anesthesia providers routinely advise patients to discard milk when receiving all types of anesthesia. The purpose of this project was to determine if a multimodal educational module and cognitive aid improved student registered nurse anesthetists' knowledge and confidence to counsel lactating patients on current anesthesia-related recommendations. DESIGN: This project used a pre-experimental one-group, pretest and post-test design. METHODS: Preintervention and postintervention surveys measured knowledge and confidence to counsel lactating patients scheduled to receive anesthesia. FINDINGS: Significant improvement in knowledge and confidence after the intervention were noted. CONCLUSIONS: A multimodal educational session and cognitive aid improved student registered nurse anesthetists' knowledge about current anesthesia-related breastfeeding recommendations and their confidence in counseling these patients. Wider use of this educational module with the cognitive aid has the potential to positively impact breastfeeding patients and their children.

Best Practices for the Care of Breastfeeding Patients Requiring Local or General Anesthesia.

The care of breastfeeding patients who require anesthesia presents unique challenges; therefore, caregivers must be knowledgeable regarding drugs' pharmacodynamic and pharmacokinetic profiles to ensure the safety of the breastfed infant. Although most anesthetic drugs are compatible with breastfeeding, health care providers continue to advise patients to "pump and dump." This advice can lead to undesirable outcomes, including interruption or cessation of breastfeeding, creating possible physical and psychological challenges for parents and their neonates. This article outlines best practices for the care of breastfeeding patients receiving anesthesia.

Stress, Anxiety, and Well-being in Nurse Anesthesia Doctoral Students.

An emerging degree program of student registered nurse anesthetists (SRNAs) enrolled in a doctoral program of study exemplifies a highly challenging educational path with intense clinical and academic requirements. The focus of this study was to address the lack of research about SRNAs' stress, anxiety, and well-being by exploring responses from the newest doctoral cohorts. Students who were enrolled in a doctoral nurse anesthesia program of study from a small urban university completed valid and reliable questionnaires measuring self-perceived stress, anxiety, and distress. Other questions revealed students' perceptions of performance, experiences, and suggestions for improvement. Results were analyzed using statistical software (SPSS version 24.0, IBM Corp) and open-coded thematic analysis. Significant results revealed that as numbers of SRNAs with low well-being increased, so did levels of anxiety (P=.02), perceived stress (P=.001), and perceived impacts on academic performance (P=.003). Open-ended questions described students' perceptions of stress, new-onset anxiety, poor well-being, and a lack of support and provided suitable suggestions for improving well-being in students. The prevalence of stress, anxiety, and low well-being among SRNAs enrolled in a doctoral program suggests the need for developing interventions and educational changes to improve the well-being of students in the anesthesia community.