Date of Award

12-2019

Document Type

Dissertation - Campus Access Only

Degree Name

Doctor of Nursing Practice

Degree Discipline

Nursing

Abstract

One of the most frequent complications of regional anesthesia during labor is an unintentional dural puncture (UDP). While most patients that experience UDP do not develop complications and have an uneventful post-partum recovery, some women develop complications, such as a post-dural puncture headache (PDPH). The complications of a UDP can affect a new mother's health, ability to care for her infant, and feelings regarding her post-partum recovery; therefore, it is essential for anesthesia providers to follow-up on patients with known UDP.

The objective of this quality improvement project was to change current practice for anesthesia providers regarding the identification of patients who had experienced UDP from regional anesthesia for labor at the practice site. The project supported the framework for the development and implementation of an electronic provider tool to appropriately identify patients.

This quality improvement project employed a pre-/post-study design to assess change in the documentation of UDPs by anesthesia providers following the implementation of an electronic health record (EHR) tool compared to paper logbooks.The study design also allowed for accurate measurement of UDP rates postimplementation of the electronic provider identification tool.

The overall findings confirrned a significant difference in the total number of identified UDP patients after the implementation of an electronic provider tool. In addition, a statistically significant difference between methods was observed (12 — 12.842, df= 1, p = < .001). The proportion of patients identified with UDP in 2019 (n=36) was more than double that in 2019 (n=36) compared to 2017 (n=16) and 2018 (n=15) over the 6-month implementation period. Also, the percentage of UDPs recorded in the electronic provider tool was 3.4%, which was notably higher than the UDP rates in other current research studies.

The outcome of this quality improvement project was improved identification and documentation of UDP patients via the use of the electronic provider tool within the hospital's EHR. This finding was consistent with improvements reported by other research studies that evaluated both the conversion from paper health records to EHR along with the evaluation of assessment tools used in EHR.

Committee Chair/Advisor

Vivian Dawkins

Committee Member

Ruby A. Benjamin- Garner

Committee Member

Jerrel Moore

Committee Member

Hector Pina

Publisher

Prairie View A&M University

Rights

© 2021 Prairie View A & M University

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Date of Digitization

11/21/2024

Contributing Institution

John B Coleman Library

City of Publication

Prairie View

MIME Type

Application/PDF

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