Date of Award

Fall 12-2016

Degree Type

Doctoral Nursing Capstone Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chair

Dr. Patsy Anderson

Committee Chair Department

Nursing

Committee Member 2

Dr. Cathy Hughes

Committee Member 2 Department

Nursing

Committee Member 3

Dr. Marjorie Geisz-Everson

Committee Member 3 Department

Nursing

Abstract

In the United States, 61% of parturient patients elect neuraxial anesthesia for labor pain (Koyyalamudi et al., 2016). The incidence of postdural puncture headache is estimated up to 81% following accidental dural puncture-especially in pregnant women receiving elective epidurals (Ragab & Facharzt, 2014). Although the combined rates of complications for spinal and epidural anesthesia are low (2.78%) (American Society Anesthesiologists, 2014), patient safety is extremely important and should be addressed by the overall healthcare system. The purpose of this project assessed a willingness to change which focused on the CRNAs incorporation of proper positioning education prior to neuraxial anesthesia into their plan of care. Current and past literature was synthesized to offer a practice change recommendation to Certified Registered Nurse Anesthetists at a local hospital in Southeastern Mississippi. The recommendation described the benefits of educating parturient patients prior to neuraxial anesthesia. Thirty-four Certified Registered Nurse Anesthetists took part in a survey after the presentation of evidence regarding parturient education prior to neuraxial anesthesia. All of the participants agreed to incorporate proper positioning education into their plan of care for the parturient population prior to neuraxial anesthesia. Descriptive and nonparametric statistics were used to analyze the data. This practice change supports patient safety initiatives outlined by the Institute of Medicine and American College of Obstetricians and Gynecologists.

Keywords: PDPH, postdural puncture headache, post dural puncture headache, post-dural puncture headache, patient positioning, spinal anesthesia, epidural anesthesia, regional anesthesia, neuraxial anesthesia, spinal headache, parturient education, obstetric safety, patient safety, labor pain

ORCID ID

orcid.org/0000-0001-9272-8207

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