58 - Preparing Staff for Bone Cement Implantation Syndrome

Description:

Background:
Bone Cement Implantation Syndrome (BCIS) is a rare but potentially life-threatening complication that can occur during arthroplasty procedures involving cemented implants. Although infrequent, its consequences can be severe, including hypoxia, hypotension, cardiac arrhythmias, and even cardiac arrest. At our Level I trauma center, nearly 300 arthroplasty surgeries are performed annually, making it essential for perioperative nurses to recognize and respond effectively to BCIS.

Team

Description:
The initiative was led by orthopedic surgery circulators, also included in the multidisciplinary team was scrub nurses, perioperative educators, anesthesia providers, and orthopedic surgeons.

Preparation and Planning:
Recognizing the need for enhanced awareness, the orthopedic nursing team collaborated with educators and the surgical team to develop a comprehensive educational session. A lecture-style presentation was created, focusing on the etiology, risk factors, recognition, and response strategies for BCIS. An in-service date was selected during the designated Wednesday morning education hour, allowing for participation from all perioperative staff.

Assessment:
A needs assessment revealed a significant knowledge gap regarding BCIS among circulating and scrub nurses. Given the volume of arthroplasty cases and the large number of perioperative staff — over 110 nurses who may participate in these surgeries — education on this topic was deemed critical for patient safety.

Implementation:
The BCIS training was delivered during the one-hour weekly in-service session. It included an evidence-based lecture supplemented by a pre- and post-education survey to assess baseline knowledge and improvement. Case studies and visual aids were used to enhance understanding and engagement.

Outcomes:
Following the in-service, staff reported increased confidence in identifying high-risk patients and greater preparedness to recognize and respond to intraoperative BCIS events. The pre- and post-survey results demonstrated measurable improvement in knowledge and situational awareness among perioperative staff.

Implications for Perioperative Nursing:
Equipping perioperative nurses with knowledge of BCIS empowers them to advocate for patient safety during joint replacement surgeries. Nurses who understand the risk factors and early signs of BCIS can collaborate effectively with the surgical and anesthesia teams to prevent complications, modify surgical techniques when appropriate, and implement prompt intraoperative interventions. This initiative underscores the vital role of perioperative nursing education in improving patient outcomes and surgical safety.