Date of Award

Fall 12-9-2021

Degree Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Nina Mclain

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Stephanie Parks

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

The pre-anesthesia evaluation (PAE) is a vital component to anesthesia providers when choosing an appropriate anesthetic plan for patients requiring surgery. The PAE, pre-anesthesia risk-factor assessment, and provision of pre-anesthesia instructions are standards of care implemented in order to assess the patient’s likely outcome of surgery and anesthesia as well as stratify any known risk factors to optimize surgical/anesthetic outcomes. Any disruption in this process could potentially lead to decreased patient/provider satisfaction, reduced patient compliance with pre-anesthetic instructions, reduced patient safety, and unnecessary financial burden.

After the completion of a literature review, the need for a best practice recommendation was identified and a document was created containing a Pre-Anesthetic Take-Home Evaluation (PATHE). PATHE specifically aims to improve the pre-anesthesia assessment process through increased patient reporting of pertinent health history, stratification of pertinent risk factors, and pre-anesthesia education.

The PATHE document was provided to seven practicing certified registered nurse anesthetists (CRNAs) and 22 student registered nurse anesthetists (SRNAs) currently in clinical. Of the respondents, 100% agreed that the document was thorough, well organized, and free from grammatical and formatting errors. Twenty-eight respondents (96.55%) agreed that the document would be easy for adults (age > 18 years) of all cognitive levels to comprehend; however, one respondent (3.45%) disagreed. Additionally, 100% of respondents agreed that the document provides a clear representation of all majors aspects of anesthesia care, addresses most commonly encountered questions from patients, provides an accurate depiction of all topics addressed, addresses most commonly encountered risks associated with anesthesia, solicits the minimal amount of information required to develop a safe and effective plan for anesthesia care, provides a clear and accurate list of risks, and provides recommendations for risk stratification that are supported by current evidence. Lastly, one constructive comment left by a respondent stated that the document was too long, which could potentially deter patient compliance.

With consideration of the literature review and survey results, the authors have concluded that patients, healthcare providers, nurses, and healthcare facilities all stand to benefit from the implementation of PATHE into their current evidence-based practice.

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