Date of Award

Fall 9-28-2018

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Marjorie Everson

Committee Chair Department

Nursing

Committee Member 2

Dr. Michong Rayborn

Committee Member 2 Department

Nursing

Committee Member 3

Dr. Cathy Hughes

Committee Member 3 Department

Nursing

Abstract

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at any given time (Chou et al., 2016; Duncan & Haigh, 2013; Nagelhout & Plaus, 2014). Epidural analgesia needs improvement because it has been linked to a failure rate of 30% in clinical practice (Duncan & Haigh, 2013). The purpose of this DNP project was to perform an epidural policy analysis at a hospital in Mississippi.

Questionnaires were collected from critical care nurses and anesthesia providers. Seventy-five percent of critical care nurses and anesthesia providers were not aware that epidural analgesia has a 30% failure rate. Also, 50% of nurses and 95% of anesthesia providers believed that having up-to-date, accessible policies outlining epidural care, and management can improve postoperative epidural analgesia. One hundred percent of nurses and 95% of anesthesia providers believed their institution’s epidural policy demonstrates areas for improvement. Lastly, 75% of nurses and 95% of anesthesia providers felt that the hospital would benefit from an updated epidural policy.

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at any given time (Chou et al., 2016; Duncan & Haigh, 2013; Nagelhout & Plaus, 2014). Epidural analgesia needs improvement because it has been linked to a failure rate of 30% in clinical practice (Duncan & Haigh, 2013). The purpose of this DNP project was to perform an epidural policy analysis at a hospital in Mississippi.

Questionnaires were collected from critical care nurses and anesthesia providers. Seventy-five percent of critical care nurses and anesthesia providers were not aware that epidural analgesia has a 30% failure rate. Also, 50% of nurses and 95% of anesthesia providers believed that having up-to-date, accessible policies outlining epidural care, and management can improve postoperative epidural analgesia. One hundred percent of nurses and 95% of anesthesia providers believed their institution’s epidural policy demonstrates areas for improvement. Lastly, 75% of nurses and 95% of anesthesia providers felt that the hospital would benefit from an updated epidural policy.

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