Date of Award

Fall 2024

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

DNP

Degree Name

Other

First Advisor

Cathleen Colleran

Second Advisor

Courtney Coffey

Abstract

Background: Airway management has always been central to critical care; it is a complex skill to learn and necessary for patient survival. To properly care for a patient’s airway, the provider must fully understand airway anatomy including upper and lower anatomy and how they work together to allow for oxygen transportation (Day, 2022). Unfortunately, many nursing school curriculums and department orientations are not able to provide the level of education and training necessary. Due to an extreme nursing shortage, many hospitals are not able to provide in depth orientations upon hire and annual review, this lack of professional support affects both patients and staff. Methods: In order to improve education, an advanced airway management course has been developed to provide new hires, new graduates as well as seasoned staff the opportunity to practice and perfect many skills. All operating room and pacu nurses were asked to attend a power point based lecture where airway anatomy and common airway emergencies were reviewed. After the presentation nurses were given the opportunity to practice bag-mask ventilation, assemble a Mapleson breathing circuit and find critical equipment in an unlocked code cart. Ekg rhythms and lung sound assessments were also reviewed with opportunities for remediation if needed. Intervention: To assess the effectiveness of the course, nurses were asked to complete a pre-and post-test as well as an ekg rhythm analysis and lung sound assessment exams. Additionally, the anesthesia stat pager was analyzed for three months prior to and post exam to look for a reduction in number of emergencies that occur post-operatively where anesthesia assistance is needed urgently. Results: The pre-test had an average score of 72% which increased to 88% after completion and the initial mean was 78.75% which increased to an impressive 94% after attendance. For three months prior to the course the anesthesia stat pager was utilized 203 times, which decreased to 131 times after completion. There was a 36% decrease which is significant when considering the number of resources that could potentially be required for even one page. The decrease in pages also indicates that fewer patients are experiencing complications, hopefully expediting their discharge home or planned admission to a floor. Conclusion: Overall, the results from this quality improvement project demonstrated a higher understanding of different airway emergencies and the proper interventions after attendance at the advanced airway management course. Qualitative data indicates improvement in understanding and nurses self-reported feeling more confident in decision making and utilizing emergency equipment. The course has now been incorporated into annual training to help create an empowered and skilled workforce.

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