Defense Date
7-17-2025
Graduation Date
Summer 8-31-2025
Submission Type
Dissertation/Thesis
Degree Name
Doctor of Nurse Anesthesia Practice
Department
Doctor of Nurse Anesthesia Practice (DNAP) Program
School
School of Nursing
Keywords
Black women, cesarean delivery, cesarean section, general anesthesia, epidural catheter, labor epidural, marginalized, rounding tool, labor analgesia
Abstract
Neuraxial anesthesia has significantly reduced anesthesia-related maternal morbidity during the peri-partum period. Despite these advancements, racial disparities persist in obstetric anesthesia care and Black women continue to experience disproportionately higher rates of general anesthesia (GA) for cesarean delivery when compared to non-Hispanic White patients. This quality improvement (QI) project sought to decrease the conversion from epidural anesthesia to GA for cesarean sections in laboring women by creating an epidural catheter assessment tool. The epidural catheter assessment tool provided uniform assessment and documentation of labor epidurals by anesthesia providers to reduce the use of general anesthesia for unplanned cesarean section deliveries. Utilizing the Plan-Do-Study-Act (PDSA) quality improvement design, the project began by evaluating the process for epidural catheter assessments to identify the factors contributing to the conversion from epidural anesthesia to GA for cesarean section deliveries. The Epidural Catheter Assessment Tool (ECAT) was developed to guide consistent assessment, evaluation, and documentation of dermatomal level, laterality, and sensory/motor blockade of the labor epidural in a labor and delivery unit in Southwestern Pennsylvania. A six-question survey was distributed to 19 anesthesia providers. Ninety percent reported that the ECAT helped identify poorly functioning epidurals, supporting its potential to promote equity in obstetric anesthesia care.
Language
English
Recommended Citation
Saunders, Marjani A. and Pannell, Tyler-Nicole, "Implementation of an Epidural Catheter Assessment Tool to Reduce the Risk of Racial and Ethnic Disparities Associated with the Conversion to General Anesthesia in Cesarean Deliveries: A Quality Improvement Project" (2025). Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts. 1.
https://dsc.duq.edu/dnap/1