Assessing Certified Registered Nurse Anesthetists' Perception of the Usefulness of a Reference Guide in Managing Amniotic Fluid Embolism: A DNP Project

Abstract

Amniotic fluid embolisms are rare obstetric emergencies that threaten the lives of both the parent and fetus. It contributes to 7.5% of maternal deaths, with incidence rates ranging from 1.2 to 5.5 per 100,000 deliveries. Due to differences in diagnostic standards across the globe, creating uniform testing and management protocols remains difficult. A literature review was conducted to develop a reference guide based on current recommendations from organizations, including the American College of Obstetricians and Gynecologists, the Anesthesia Patient Safety Foundation, and the American Association of Nurse Anesthesiology. A partnering facility was chosen for this new reference guide because of the opportunity to create guidelines for managing these emergencies. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the usefulness of a new reference guide for CRNAs in recognizing and managing amniotic fluid embolism events. A pre-implementation survey revealed that none of the participants had experience managing a patient with an amniotic fluid embolism, nor had they received in-service training or education on this disease process since graduation. Following a presentation on the pathophysiology of amniotic fluid embolism and an orientation to the reference guide, a post-implementation survey revealed that participants found the guide to be well-organized, relevant, accurate, and easy to understand, perceiving it as useful. Limitations of this project included its small sample size. Future recommendations should involve increasing the sample size, expanding the project population, and including multiple implementation days.