Date of Award

Fall 2021

Degree Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Michong Rayborn

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Nina McLain

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

Epidural anesthesia is the mainstay choice to provide parturient patient pain relief during the laboring process. However, the incorrect placement of an epidural catheter can result in inadequate control of labor pain and other adverse complications to both mother and fetus. Aside from normal physiologic changes that occur during pregnancy that may contribute to difficulty in placing an epidural catheter, obesity further complicates the procedure by further obscuring anatomical landmarks that are traditionally used for epidural placement in non-obese parturient (Brodsky & Mariano, 2011). As the prevalence of obesity is rising in the United States, anesthesia providers may face more difficulty in placing epidural catheters and providing adequate analgesia to the obese laboring patient. Current literature has shown that by including the utilization of additional tools such as ultrasound-guidance and the traditional landmark-based technique during epidural placement in an obese laboring patient, both anesthesia providers and patients will benefit.

This doctoral project focused on creating an educational module that includes information and video demonstrations in the form of a PowerPoint™ presentation for utilizing ultrasound guidance for epidural placement in obese laboring patients. The educational module was sent to 20 student registered nurse anesthetists (SRNA) in their third year of the nurse anesthesia program and an expert panel consisting of four certified registered nurse anesthetists (CRNA) who are also faculty of the nurse anesthesia program. They were all considered to be relevant stakeholders due to their knowledge concerning regional anesthesia. A post-educational module survey was also sent to each participant to complete afterward to evaluate the educational module’s effectiveness and allowed additional comments and feedback from the participants. All of the stakeholders found the educational module informative on the utilization of ultrasound for epidural placement in obese laboring patients. The expert panel unanimously agreed that this educational module was informative and would consider a practice change in their current practice.

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