Bonnie Molloy, Ph.D. a clinical faculty member of Fairfield University's School of Nursing , has been awarded a prestigious fellowship, green lighting her compelling research into how a patient's position during surgery can cause blindness.

As the recipient of the 2011 American Association of Nurse Anesthetists (AANA) Foundation Postdoctoral Fellowship, Dr. Molloy will receive $50,000 for her patient study to be conducted at Bridgeport Hospital and the Hospital of Saint Raphael in New Haven, Conn. The AANA fellowship is designed to cultivate the development of leaders within the nurse anesthesia specialty.

A Fairfield, Conn. resident, Dr. Molloy is a nurse anesthetist who teaches in Fairfield University's Doctor of Nursing Practice Program that is offered in conjunction with Bridgeport Hospital and Bridgeport Anesthesia Associates. "We have realized that the head down position - steep Trendelenburg - for prolonged procedures during lower robotic and laparoscopic procedures can be deleterious and can result in permanent blindness," said Molloy, the chief certified registered nurse anesthetist of Bridgeport Anesthesia Associates' and director of research of the anesthesia department at Bridgeport Hospital.

Molloy's study ultimately aims to provide anesthesia caregivers with a convenient and reliable observation scale that predicts critical increases in a patient's intraocular pressure (IOP), or pressure inside the eyes, that may cause visual loss following surgery. More than 2,000 patients worldwide have lost their sight after prolonged, head down surgical procedures that led to rising intraocular pressure. Moreover, Molloy has come up with two protective measures to possibly prevent the problem.

For her dissertation, Molloy studied patients undergoing robotic or laparoscopic surgery - now the more common less invasive surgical approach nationwide over the traditional practice of large lower abdominal incisions. With the assistance of Fairfield nurse anesthesia students, the newest study looked at several physical conditions of a patient that, during surgery, correlated to rising intraocular pressure. Interestingly, robotic and laparoscopic procedures often have patients with the head of the operating table tilted downward, so that the bowel will move away from the lower abdominal organs. Traditionally, patients lay on flat operating tables, so this eye pressure concern wasn't an issue.

To help anesthesia caregivers, Molloy has helped develop a scale of measure, 'the Molloy/ Bridgeport Anesthesia Associates Observation Scale' (MBOS) that calls for monitoring several physical conditions, including eyelid edema, conjunctival edema and ecchymosis. In past research, she has correlated these three conditions to rising intraocular pressure. The hope is that, thanks to the research, caregivers can utilize this observational scale, the MBOS, to alert caregivers as to when patients may need treatment interventions that would normalize intraocular pressure.

"I now have two interventions that we have trialed to prevent against this low flow state," said Molloy. They include the administering of eye drops to bring down the pressure and a "supine rest stop" during surgery, requiring the patient be removed from the head down position for five to seven minutes.

"This grant is allowing us to extend our eye drop study and to perform the same interventions at St. Raphael's Hospital so as to potentially decrease the potential for postoperative visual loss," added Molloy. "Nursing students from Fairfield will help with the Bridgeport Hospital part of the study."

Molloy has spent the past 25 years of her professional life in outcome based practice review to procure a level of safety for all patients undergoing anesthesia. The Yale Healthcare System is among the organizations that have recognized her for her clinical research. In addition to being a member of Fairfield's School of Nursing Advisory Board, Molloy and her husband, Edward, an internist at St. Vincent's Medical Center, have been members of the university's President's Circle for more than 25 years.

For more information about Fairfield's School of Nursing, visit http://www.fairfield.edu/son/dnp_index.html .

Posted On: 06-29-2011 11:06 AM

Volume: 43 Number: 331