Date of Award

Fall 9-25-2020

Degree Type

Dissertation/Thesis

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

The current practice of intraoperatively assessing the cuff pressure of the endotracheal tube (ETT) is arbitrary and potentially leads to negative impacts on patients. This best practice project aimed to review and synthesize the existing evidence-based literature on measuring ETT cuff pressure and to establish a policy guideline for anesthesia providers to measure ETT cuff pressure in the intraoperative environment. Based on the star model of the knowledge transformation framework model provided by the Academic Center for Evidence-Based Practice (ACE), the creation of evidence-based policy on ETT cuff measurement is expected to potentially prevent poor patient outcomes, patient expenses, and hospital expenses (Chism, 2019). Also, the use of the IHI Triple aims at improving patients' safety, enhancing effectiveness, contributing to the implementation of the patient-centered approach, as well as the provision of timely and efficient care to improve patients' experiences (Whittington et al., 2015). A comprehensive literature review was undertaken to evaluate and synthesize the latest evidence-based research that can be used to improve the measurement policy of the endotracheal tube cuff pressure. The established evidence-based policy was emailed to the expert panel for review and assessment per the protected server at The University of Southern Mississippi (USM). The best practice policy recommendation regarding postoperative complications caused by over-inflated ETT was conducted at a USM clinical affiliate hospital in Mississippi. A DNP committee, will be used to assess the utility and practicality of the policy(stakeholders). In addition to quantitative measurements of a clinical affiliate's ETT pressure, qualitative feedback from a DNP committee, was used to assess the evidence-based policy. Policy revisions were made based on data collected from the ACE tool.

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