The Development and Validation of an Objective Assessment Tool for Performing Ultrasound-Guided Transversus Abdominal Plan Blocks-The Development and Validation of an Objective Assessment Tool for Performing Ultrasound-Guided Transversus Abdominal Plan Blocks

The Development and Validation of an Objective Assessment Tool for Performing Ultrasound-Guided Transversus Abdominal Plan Blocks

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The article from the AANA Journal discusses the development and validation of a checklist for performing ultrasound-guided transversus abdominis plane (TAP) blocks, a technique used in regional anesthesia for pain management in abdominal surgeries. Despite the TAP block's popularity due to its high safety profile, the variability in techniques can lead to inconsistent outcomes and potential patient risks, highlighting the need for a standardized competency assessment tool.<br /><br />The study aimed to create a checklist using the modified Delphi method, with a focus on validation through expert consensus and Messick’s validity framework. A 43-item checklist was developed and validated by six certified registered nurse anesthetists (CRNAs) from the United States, requiring three rounds of feedback to achieve the necessary consensus.<br /><br />The checklist is divided into Preprocedure, Intraprocedure, and Postprocedure sections, and modifications were made based on expert feedback. Five items were adjusted for clarity, reflecting the balance between recommended guidelines and practical variability observed among professionals.<br /><br />While the checklist was successfully validated, its development noted limitations such as a relatively small and geographically limited expert panel. Additionally, debates about various technical aspects of TAP block performance persist, pointing to ongoing challenges in standardizing techniques.<br /><br />The checklist offers a structured approach to evaluating TAP block proficiency, with potential implications for both educational settings and clinical practice. However, further research is needed to explore its effectiveness and the broader impact on patient outcomes. Future projects are encouraged to address the variations in TAP block technique and nomenclature to improve the reliability and applicability of such assessment tools in medical practice.

Keywords

ultrasound-guided TAP block

regional anesthesia

pain management

checklist development

Delphi method

Messick’s validity framework

competency assessment

CRNA validation

standardization

clinical practice