Certified Registered Nurse Anesthetist Perception of the Usefulness of a Standardized Reference Guide for the Management of Amniotic Fluid Embolism: A DNP Quality Improvement Project

Abstract

AFE is a life-threatening complication of pregnancy with a high mortality rate that currently has no standardized or nationally agreed-upon protocols for treatment based on current best practices. Reference guides or cognitive aids are used in a wide array of emergencies. They can play an important role in helping the provider with a step-by-step approach to managing emergencies, such as amniotic fluid embolism. Evidence shows that a team-based approach to emergencies improved with the use of a(CA) or reference guide, and the rate of errors during emergencies was reduced by 50%. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate the perception of usefulness of a new reference guide among CRNA participants for improving the management of amniotic fluid embolism via an in-person presentation. This quality improvement project occurred at a small outlying facility in eastern North Carolina with all participants in attendance at the presentation. Data was collected via pre- and post-implementation surveys using Qualtrics and analyzed using Microsoft Excel. The results showed an overall acceptance of the reference guide, a plan to implement the reference guide into their management of amniotic fluid embolism, and an increase in confidence when managing an amniotic fluid embolism event. Limitations to this project included the small number of participants available for implementation in a single facility. Future projects expanding on the work of this DNP project could include a simulation scenario allowing participants to practice using the reference tool in an amniotic fluid embolism event.