Graduation Date

8-2026

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nurse Anesthesia Practice

Department

Doctor of Nurse Anesthesia Practice (DNAP) Program

School

School of Nursing

Faculty Mentor

Rebecca Vrescak

Committee Member

Sarah Zangle

Keywords

quality improvement, anesthesia, Pitocin, observational data, evidence-based practice

Abstract

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, and identify opportunities to improve patient safety and reduce postpartum hemorrhage risk through future protocol development. Data were collected through direct observation of Pitocin administration during cesarean deliveries and structured questionnaires completed by anesthesia providers. Findings demonstrated consistent use of gravity-based administration regulated by roller clamp rather than infusion pump use, variability in timing of initiation, and inconsistent uterine tone assessment and documentation practices. These findings support recommendations for development of an evidence-based, institutionally approved Pitocin administration protocol, provider education, and future evaluation of maternal outcomes following standardization.

Language

English

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