Date of Award

Spring 5-9-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Cynthia Schmidt

Project Team Faculty Member

Dr. Adam Schneider


postoperative vision loss, POVL, steep Trendelenburg, risk reduction, cognitive aid


Postoperative vision loss (POVL) is a rare, but devastating complication that has been reported following robot-assisted laparoscopic surgeries that require prolonged steep Trendelenburg positioning. A central Illinois hospital had recently established a robot-assisted surgical program but lacked active interventions to reduce POVL risk due to a knowledge gap of the anesthesia providers. Following a comprehensive literature review, a PowerPoint educational program was provided at an anesthesia staff meeting. An evidence-based cognitive aid to provide a quick reference of POVL risk reduction strategies was created by the author in collaboration with the stakeholder. Once approved, the cognitive aid was attached to the anesthesia machine. A post-presentation survey was used to evaluate the effectiveness of the teaching methods and to determine if the anesthesia staff intended to incorporate the teachings into their practice. The results of the survey indicated all participants perceived an increase in their knowledge and reported a willingness to implement POVL risk reducing strategies. A POVL Checklist was used to track which interventions were used in the hospital during a two-month period. Although few surgeries consistent with POVL risk were conducted, four completed POVL Checklists were submitted and indicated practice change. The predicted long-term impact is that the cognitive aid will continue to be used with appropriate patients, evidence-based interventions will be implemented to reduce POVL risk, and the providers will revise the guidelines when new evidence is available.

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