Semester

Summer

Date of Graduation

2022

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Not Listed

Committee Chair

Mike Frame

Committee Co-Chair

Benjamin Blick

Committee Member

Benjamin Blick

Committee Member

Matthew Camerlin

Abstract

Spinal anesthesia is an excellent choice as the primary anesthetic for lower abdominal, perineal, and lower extremity procedures. Spinal anesthesia boasts several distinct advantages over general anesthesia. However, it is important to note that spinal anesthesia does not come without risk. The most common adverse reaction of spinal anesthesia is hypotension. Anesthesia providers use several methods to combat the hypotension that is so commonly associated with spinal anesthesia. One emerging trend to prevent spinal anesthesia-induced hypotension (SAIH) is the administration of ondansetron, a serotonin 5-hydroxytryptamine3 antagonist. Evidence has shown that the administration of ondansetron just prior to spinal anesthesia administration may decrease the prevalence of SAIH by blocking the serotonin receptors in the heart, thus preventing the triggering of the Bezold-Jarisch Reflex, a triad of hypotension, bradycardia, and peripheral vasodilation. Despite the mounting evidence supporting the use of ondansetron to prevent this phenomenon, it has not been widely adopted as the standard of care. The purpose of this project was to translate evidence-based anesthesia care of patients undergoing spinal anesthesia into practice by increasing anesthesia provider knowledge regarding the efficacy of pre-spinal anesthetic ondansetron in attenuating SAIH. An educational in-service was delivered to anesthesia providers at a 292 private-bed community hospital in West Virginia regarding the efficacy of ondansetron in the mitigation of SAIH in an attempt to increase provider knowledge about the usefulness of this intervention. Nineteen anesthesia providers took part in the in-service. Pre- and post-intervention Likert surveys were delivered that assessed the providers’ knowledge regarding the intervention, current use of the intervention in his or her practice, and willingness to adopt the intervention if sufficient evidence supports the change. It was concluded that the in-service increased provider knowledge regarding the use of ondansetron in the attenuation of SAIH and influenced an intended change in provider practice. Continuing education should be utilized to inform the evolution of evidence-based practice in anesthesia.

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