Graduation Date
Summer 8-7-2026
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 Vresack
Keywords
goal-directed fluid therapy, non-invasive hemodynamic monitoring, cesarean delivery, postpartum hemorrhage, cognitive aid
Abstract
Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, with delayed recognition contributing to adverse outcomes during cesarean delivery. In cesarean deliveries, traditional intermittent non-invasive blood pressure monitoring may not detect early hemodynamic instability, creating a need for more structured interpretation of continuous hemodynamic data. This Doctor of Nurse Anesthesia Practice quality improvement project implemented a cognitive aid to support anesthesia providers using the Edwards EV1000/ClearSight platform during goal-directed fluid therapy. A pre–post implementation design using provider surveys evaluated feasibility, usability, confidence, and perceived impact. By organizing continuous values such as stroke volume, cardiac output, and systemic vascular resistance into a concise decision-support tool, the intervention aimed to reduce practice variation, improve provider confidence, and promote earlier recognition of clinical deterioration during cesarean delivery. Post-implementation findings suggested that providers perceived the cognitive aid as helpful for interpreting EV1000/ClearSight data and making more targeted fluid and vasopressor decisions based on objective hemodynamic values rather than estimation.
Language
English
Recommended Citation
George, Ashley and Walbert, Ashley, "Implementation of a Cognitive Aide to Guide the Use of Non-Invasive Hemodynamic Monitoring for Goal-Directed Fluid Therapy During Cesarean Deliveries" (2026). Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts. 8.
https://dsc.duq.edu/dnap/8