Defense Date

7-20-2026

Graduation Date

Summer 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

Keywords

SBAR, obstetric anesthesia, patient handoff, communication, quality improvement, CRNA, labor and delivery, patient safety, Epic EHR, interdisciplinary communication

Abstract

Effective communication during obstetric handoffs is essential for promoting maternal and neonatal safety, yet communication failures remain a significant contributor to adverse events due to inconsistent and unstructured handoff practices. This Doctor of Nursing Anesthesia Practice (DNAP) quality improvement project was developed following the recommendations of the 2025 DNAP project, which implemented the OB/L&D-specific SBAR tool. This project evaluated the use of this communication tool in areas of OB interdisciplinary team communication accuracy, efficiency, and collaboration, particularly during obstetric epidural requests within a community-based labor and delivery unit. Guided by the Plan-Do-Study-Act (PDSA) framework (Institute for Healthcare Improvement, 2020). Utilized workflow enhancements, staff education, team member surveys, and direct observations.

Survey data found that both Certified Registered Nurse Anesthetists and Registered Nurses reported more consistent SBAR utilization, improved completeness of patient information, enhanced shared understanding of clinical priorities, and greater satisfaction with communication processes. Survey results also indicated that inconsistent communication methods, differing expectations between nursing and anesthesia providers, and lack of telecommunication support limited adherence to the OB/L&D SBAR process. The lack of integration of the SBAR structure in the Epic system made implementing the 2025 recommendations impossible. Instead, this project implemented the use of OB/L&D SBAR SmartPhrase to overcome the lack of Epic integration. Post-implementation surveys indicated improved team communication. Further recommendations include ongoing evaluation of the OB/L&D SmartPhrase and its use in daily interdisciplinary huddles. Collectively, these strategies support long-term sustainability, strengthen patient safety initiatives, and promote a culture of evidence-based communication within the obstetric setting.

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