Anesthesia Providers’ Perceptions of a Cognitive Aid for the Management of Amniotic Fluid Embolism: A Doctor of Nursing Practice Project

Abstract

Amniotic fluid embolisms (AFE) are a rare but life-threatening obstetrical emergency associated with high maternal mortality. The purpose of this quality improvement project was to assess anesthesia providers’ perceptions of a cognitive aid to aid in identifying and managing AFE. The cognitive aid was developed following a synthesis of literature and distributed during an informational session to Certified Registered Nurse Anesthetists (CRNAs) at a partnering facility. The CRNAs responded to pre- and post-implementation surveys regarding their perceptions of the usefulness of the cognitive aid. Results indicated that the anesthesia providers felt that the CA was well-designed and easy to use. CRNAs reported increased confidence in AFE identification and management following the presentation and CA dissemination. Finally, the CA also increased the speed of locating information regarding the identification and management of a suspected AFE. By enhancing CRNA confidence and reducing the time required to access critical information, the cognitive aid may contribute to earlier intervention, more coordinated team responses, and ultimately, improved patient outcomes during one of the most time-sensitive emergencies in obstetric anesthesia. Recommendations for future versions of this project include the development of a multidisciplinary simulation program incorporating the cognitive aid into AFE emergency management scenarios.