ASRA Conference Coverage

Improving Clinical Recognition of Peripheral Nerve Block Risks Through Visual Alerts, Staff Education

Anthony Calabro, MA

Key Highlights

  • 100% of staff post-intervention agreed the alert sign improved awareness of nerve block risks.
  • Pre-intervention communication about nerve blocks was inconsistent across providers.
  • The initiative involved a visible “NERVE BLOCK: FALL/INJURY RISK” sign and multidisciplinary education.
  • Visual identification of patients with nerve blocks helped mitigate the risk of adverse safety events.

A staff education and signage initiative improved multidisciplinary team awareness of peripheral nerve blocks (PNBs) in patients who underwent orthopedic oncology operations, significantly enhancing patient safety at The University of Texas MD Anderson Cancer Center in Houston, TX. The study authors presented the results from their Patient Safety Award-winning study at the 50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting in Orlando, FL.

Peripheral nerve blocks are widely used in orthopedic oncology surgeries to manage perioperative pain. However, due to the resulting motor and sensory impairments, these blocks pose a fall and injury risk to patients—particularly when other health care providers are unaware of their presence. This risk is heightened by gaps in interprofessional communication and documentation, including handoffs, chart reviews, or direct notification from the acute pain medicine (APM) team.

To address this, the study team aimed to improve visibility and awareness of PNBs among clinical staff through a visual alert system and educational outreach. Researchers at MD Anderson Cancer Center designed a 3-month quality improvement initiative that included pre- and post-intervention staff surveys and a “NERVE BLOCK: FALL/INJURY RISK” sign, placed outside the rooms of patients who had received a PNB. The sign remained until the APM team confirmed resolution of the block’s effects. Staff were educated about the identification system and the associated safety goals during the intervention period.

Pre-intervention surveys indicated that although staff were aware of PNB-related impairments, communication methods varied: 50% learned about PNBs via handoff, 40% through chart review, and only 10% directly from the APM team. Post-intervention surveys showed unanimous staff agreement that the sign was visible and effective in raising awareness of the fall/injury risks posed by nerve blocks. This shift in awareness supports the use of a low-tech, high-impact approach to improving inpatient safety.

“At MDACC, the utilization of an alert ‘nerve block’ sign for orthopedic patients provided consistent visibility and increased staff awareness of fall/injury prevention,” the authors concluded.

Reference
Shrestha LA, Kurian J, Shaik G, et al. Optimizing clinical awareness following peripheral nerve blockade in orthopedic oncologic patients [poster]. Presented at: Annual Regional Anesthesiology and Acute Pain Medicine Meeting; May 1-3, 2025; Orlando, FL. https://asra.com/events-education/ra-acute-meeting.