Date of Award

12-2025

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. Allan Lovern

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

The purpose of this doctoral project was to create an informative educational and evaluation tool on axillary brachial plexus nerve blocks using ultrasound-guided and landmark techniques for Certified Registered Nurse Anesthetists (CRNAs). CRNAs can use this in the clinical setting to help improve understanding and performance of axillary brachial plexus blocks. Axillary brachial plexus blocks are beneficial in providing analgesia throughout the perioperative period while minimizing risks associated with general anesthesia. Additionally, axillary blocks have a more desirable safety profile than other peripheral nerve blocks, such as supraclavicular nerve blocks. Local anesthetic systemic toxicity (LAST), due to accidental vascular puncture, is one of the most notable complications of axillary nerve blocks.

After developing an Objective Structured Clinical Examination (OSCE) for axillary blocks, the OSCE was proposed and approved by the doctoral project chair and committee member prior to approval by the Institutional Review Board (IRB) at The University of Southern Mississippi (USM). The IRB approved the doctoral project following the committee's approval. After IRB approval, the recruitment e-mail, consent, OSCE template, demonstration video, and survey questionnaire were sent to USM NAP faculty and local CRNAs.

After IRB approval and sharing with USM NAP faculty and local CRNAs, participants’ responses were collected via a Qualtrics© survey. The online platform Qualtrics© was used to develop an online survey to evaluate the effectiveness of the doctoral project. Local CRNAs and NAP faculty were asked eight questions that assessed the effectiveness of the OSCE as an adequate evaluation tool. The survey questions gathered qualitative and quantitative data. Qualitative data included consent to participate, participant demographics, and open-ended feedback. Quantitative data was collected via five questions with answer choices based on the Likert scale. The survey results indicated that 82% of the participants agreed that implementation of this OSCE would be beneficial to CRNAs in the clinical setting when performing axillary brachial plexus blocks.

Available for download on Thursday, December 11, 2025

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