Date of Award

Fall 2019

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Mary Jane Collins

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Nina McLain

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

CRNAs manage intraoperative fluid therapy as a vital part of anesthesia practice to optimize patient conditions. To maintain homeostasis, fluid therapy must incorporate the many fluid shifts that occur during the perioperative period, in particular, those patients undergoing elective colorectal surgery. Patients are at risk for under-and overhydration, both of which have detrimental effects (e.g. hypotension, pulmonary edema). Informal interviews with clinical affiliate CRNAs and lack of literature concerning CRNAs’ education of an Enhanced Recovery After Surgery fluid management protocol suggests a knowledge deficit among these anesthesia providers. Adoption of an ERAS protocol for colorectal surgery entails implementing a goaldirected program that aims at decreasing perioperative stress, improving gut function and decreasing postoperative complications. The fluid management aspect of this multimodal program is where anesthesia providers can control how much fluid a patient receives based on a goal-directed regimen. An educational module with a proposed policy was prepared and presented to a expert panel, which consisted of 10 CRNAs at affiliated facilities. They were all considered relevant stakeholders due to their advanced knowledge and daily involvement with the current topic. An evaluation tool was used to gather data, which gave the panel the ability to provide feedback on the education module and proposed policy on whether the information was useful and if they would consider implementing the policy. The panel agreed that this educational module with the proposed policy was appropriate for implementation and considered it DNP quality. Majority of the panel would consider the implementation of said policy.

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