Nursing Monitoring of Microsurgical Free Flaps: Identifying and Addressing Knowledge Gaps

Area of Science:

• Microsurgery
• Nursing
• Medical Education

Background:

• Postoperative monitoring of free flaps is crucial for early detection of compromise.
• Nursing staff plays a vital role in monitoring free flap patients and alerting physicians.
• Identifying and addressing knowledge gaps in nurses is essential for optimal patient care.

Purpose of the Study:

• To identify knowledge gaps in novice and experienced nurses regarding microvascular free tissue transfer monitoring.
• To develop and implement an educational intervention to address identified knowledge deficiencies.
• To assess the impact of the educational intervention on nurses' understanding and confidence levels.

Main Methods:

• A pre- and postintervention study design was employed.
• An educational session on free flap physiology and monitoring was delivered.
• Knowledge was assessed using an 18-question multiple-choice quiz administered before and after the intervention.

Main Results:

• The average quiz score significantly improved from 61.9% to 89.3% postintervention (p < 0.001).
• Nursing experience did not correlate with preintervention knowledge levels (r_s = -0.038, p = 0.754).
• Nurse confidence in caring for free flap patients increased from 38% to 6% reporting little or no confidence (p < 0.05).

Conclusions:

• Nursing knowledge regarding capillary refill, venous congestion, and free flap physiology was initially inadequate.
• The developed in-service curriculum effectively improved nurses' understanding and confidence in free flap monitoring.
• The educational intervention was beneficial for both novice and experienced nurses.