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. Mary Jane Collins

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Jessica Miley

Committee Member 2 School

Leadership and Advanced Nursing Practice

Committee Member 3

Dr. Michong Rayborn

Committee Member 3 School

Leadership and Advanced Nursing Practice

Abstract

Airway management is one of the fundamental pillars of anesthesia. Traditionally, tools such as the Mallampati classification and the thyromental distance are used for airway assessment in the perioperative area. However, often, these methods fail to reliably predict difficult intubations. The use of point-of-care ultrasound (POCUS) has emerged as a valuable adjunct in airway assessment. However, a knowledge deficit exists among anesthesia providers regarding its application in airway assessments for perioperative adult patients. This doctoral project addressed the knowledge deficit in POCUS airway assessment among Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) through the development and implementation of an evidence-based educational intervention.

This doctoral project was supported by Adult Learning Theory and Miller’s Framework for Clinical Assessment, which provided the foundation for its design. A structured educational module was developed and paired with an Objective Structured Clinical Examination (OSCE) to evaluate competency in ultrasound-based airway assessment. Eight participants engaged in a didactic module followed by a hands-on OSCE that was focused on anatomical identification, preoperative airway assessment, such as the distance from skin-to-epiglottis (DSE) and the hyomental distance ratio (HMDR), and endotracheal tube (ETT) confirmation. Pre- and post-test surveys were completed before and after the training.

Statistical analysis indicated significant gains in participants’ knowledge, confidence, and practical skills, with improvements reaching significance across all measured domains (p < .01). Importantly, none of the participants reported prior formal instruction in POCUS airway assessment, underscoring the effect of the intervention. Following the training, participants reported higher confidence in recognizing airway anatomy, conducting ultrasound-based measurements, and confirming endotracheal tube placement.

These findings highlight the effectiveness of structured, competency-based ultrasound education in anesthesia training. Broader adoption of POCUS training has the potential to reduce airway-related complications, strengthen patient safety, and enhance provider confidence. Collectively, the results support the integration of POCUS airway training into anesthesia education.

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