Date of Award

Fall 12-7-2018

Degree Type

Doctoral Nursing Capstone Project

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Nina McLain

Committee Chair Department

Nursing

Committee Member 2

Michong Rayborn

Committee Member 2 Department

Nursing

Abstract

Instrumented multilevel spine surgery is associated with a large amount of opioid consumption, difficult mobilization, and significant pain in a population of patients who are predominantly already chronic pain sufferers (Mathiesen et al., 2013). The Health Resources and Services Administration (2018) recently claimed that our nation is in the midst of an opioid epidemic, with more than 115 opioid-related deaths occurring every year. As a result of this epidemic, many anesthesia providers have become aware and are attempting to do something about it. Organizations such as the Society for Opioid Free Anesthesia are at the forefront of the battle against the opioid crisis, promoting alternative drug therapy for pain control during and following surgery. This response has been an effort to not only prevent chronic pain but ultimately, to limit our population’s worsening dependence on opioids. One of the most common alternatives to opioids being used is dexmedetomidine. This project, inspired by the current crisis, involved the creation of a policy that details the use of intraoperative dexmedetomidine on patients undergoing instrumented spinal surgery. Collaboration with a physician anesthesiologist and an evidence review guided the development of the policy. Following completion, the policy was present to a panel of experts, which consisted of anesthesia providers who routinely take part in spinal surgery cases. Feedback was taken from the panel using a survey tool. Results of the survey revealed that the experts were willing to consider changing their practices to include dexmedetomidine as part of their anesthetic care.

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